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At least 271 records · Page 15Linked to original sources
PubMed1985

Chylothorax associated with blastomycosis in a dog.

Respiratory distress caused by pleural effusion resulted from chylothorax. Thoracic drainage and lowfat dietary therapy was effective in removing and preventing significant recurrence of the chylothorax; however, the patient died unexpectedly. At necropsy a blastomycotic granuloma found at the precava was considered the cause of the chylothorax. There had been no recognizable antemortem signs of blastomycosis. Blastomycosis can be considered as a rare cause of chylothorax.

Animals↗
PubMed1979

Blastomycosis treated successfully with miconazole.

A case of disseminated blastomycosis is described, which was treated with miconazole orally. A rapid cure was achieved without side effects. Miconazole seems to be effective and safe in the treatment of blastomycosis.

Adult↗
PubMed1972

North American blastomycosis in Central Canada. A review of 36 cases.

Experience with 36 cases of North American blastomycosis in Central Canada is reported. Symptoms referable to the respiratory tract predominated, but no uniform clinical pattern for the disease process was evident. Cutaneous and genitourinary tract involvement was present in only a small proportion of patients. The majority of the patients resided in rural areas or were associated with some form of outdoor occupation or activity. No characteristic radiologic appearance could be identified in this series. Amphotericin B administered intravenously is the treatment of choice for this condition. North American blastomycosis is more widespread on this continent than has been previously demonstrated.

Adolescent↗
PubMed1979

Acute pulmonary blastomycosis in children: clinical course and follow-up.

The clinical courses of 14 children with acute pulmonary blastomycosis were studied. All the patients had a remarkably similar illness limited to the lungs with fever, malaise, and respiratory symptoms (cough, sputum production, chest pain, and vomiting). Despite eventual recovery with treatment in all instances, 13 of the 14 children persisted in having abnormal roentgenograms. Three children have demonstrated persistent mild obstructive airway disease for two to 12 months after completion of therapy. These data suggest that the initial illness following childhood infections with Blastomyces dematitidis is usually an acute pulmonary disease without systemic dissemination. Evidence of residual lung abnormalities conflicts with the recent concept of this being a benign, self-limited illness. Our findings suggest the importance of long-term follow-up as well as a need for more complete understanding of the full clinical spectrum and prognosis of acute pulmonary blastomycosis.

Adolescent↗
PubMed1967

North American blastomycosis in California. Diagnosis of a case and a survey with 28 California observed cases.

North American blastomycosis is not seen often in California. An exhaustive survey uncovered records of only 28 cases. It is believed that this disease does not occur naturally in California and that a careful study of the history will reveal that a residence or visit to a known endemic area can be found.A chart summarizing the results of complement fixation and skin tests for coccidioidomycosis, North American blastomycosis, and histoplasmosis in the 28 cases is included. Use of all three antigens is recommended in cases where there is a difficult diagnostic pulmonary problem, even though there is occasional occurrence of cross-reactions between the three antigens. Finally, an appeal is made to be aware of other mycotic diseases non-edemic to this state.

Adult↗
PubMed1984

Laryngeal carcinoma--or is it laryngeal blastomycosis.

A patient is described who was evaluated for persistent hoarseness. Although an initial diagnosis of squamous cell carcinoma of the larynx was made, review of the pathology slides revealed pseudoepitheliomatous hyperplasia, acanthosis, and what appeared to be a fungal infection. After a detailed work-up was initiated the patient was treated successfully with ketoconazole for a blastomycosis infection of the larynx. The literature relative to blastomycosis infections of the respiratory larynx is reviewed. The authors emphasize that patients who show evidence of acanthosis and pseudoepitheliomatous hyperplasia along with the diagnosis of squamous cell carcinoma should be suspected as having a potential fungal infection.

Aged↗
PubMed1984

Treatment of canine blastomycosis with amphotericin B and ketoconazole.

The treatment of 62 dogs with blastomycosis was reviewed to identify prognostic factors and response to various treatment regimens. Severity of lung involvement, as determined by radiography, and the number of nonsegmented neutrophils were useful prognostic factors. Females survived treatment better than did males, but females were more prone to relapse. Ketoconazole treatment at a dose of 10 mg/kg daily for 60 days was not as effective as amphotericin B. The most notable adverse effect of amphotericin B treatment was nephrotoxicosis . Treatment with amphotericin B followed by ketoconazole was as effective as amphotericin B alone and resulted in less nephrotoxicosis . Most dogs that had relapses were retreated effectively with amphotericin B and/or ketoconazole. Canine blastomycosis was shown to be a treatable disease, with a cure rate of approximately 75%.

Amphotericin B↗
PubMed1982

An unusual case of North American blastomycosis in New Jersey: its clinical course and response to amphotericin B.

A seventy-six-year-old man from New Jersey developed multiple pustular lesions on his face, trunk, and extremities. These rapidly assumed a crusted appearance, and were proven, by culture and histopathology, to be North American blastomycosis. The patient was successfully treated with amphotericin B. Complement fixation studies paralleled clinical improvement and laboratory studies revealed impaired white cell function. It is postulated that the organism was first encountered fifty years earlier when the patient worked in an area in which blastomycosis was endemic.

Aged↗
PubMed1981

Blastomycosis: diagnostic difficulties.

In five cases of blastomycosis, invasive procedures were required before the diagnosis was established; these included thoracotomy in two cases and craniotomy in a third case. Radiologic signs in blastomycosis are nonspecific, and the presentations of the disease may be protean and unusual. Certain factors and radiologic appearances should alert the physician and radiologist to the diagnosis.

Adult↗
PubMed1981

Acute miliary blastomycosis after 'short-course' corticosteroid treatment.

A previously healthy patient who had received oral prednisone, 30 mg/day for 12 days, was initially seen with acute respiratory failure caused by miliary blastomycosis. This case was even more unusual because the pulmonary involvement was preceded by monoarticular arthralgias immediately before the corticosteroid therapy. The time course of these events--arthralgias, short-course prednisone therapy, and acute miliary blastomycosis--strongly suggests a relationship other than just coincidental. Treatment consisted of intravenous amphotericin B and discontinuation of therapy with the corticosteroids, and our patient is satisfactorily recovering.

Blastomycosis↗
PubMed1981

Treatment of primary pulmonary blastomycosis: results of long-term follow-up.

Twenty-three patients with pulmonary blastomycosis were seen from 1950 to 1975, and long-term follow-up, ranging from 2 to 21 years, was available for 19 patients. Four major treatment groups were identified: surgery alone (eight patients), amphotericin B alone (four patients), surgery and amphotericin B (three patients), and observation (four patients). Six of eight patients who had surgical resection alone were cured; one patient died of cardiopulmonary complications in the immediate postoperative period, and one had a relapse 15 years later. The remaining 11 patients in the three other treatment groups were cured. Although systemic therapy with amphotericin B is clearly indicated for progressive, disseminated, or incompletely resected disease, a period of observation is indicated for nonprogressive or totally resected pulmonary blastomycosis.

Adult↗
PubMed1995

Blastomycosis of the forearm synovium in a child.

Blastomyces is a pathogen that may infect healthy and immunocompromised hosts. Frequently entering the lungs, the initial pneumonitis usually is followed by skin and bony involvement secondary to hematogenous spread. Infection of the synovium without bone or skin involvement in the pediatric population has not been reported previously. A soft tissue mass of the forearm in a 9-year-old boy was the initial manifestation of blastomycosis. Radiographic images, ultrasound, and magnetic resonance imaging of the forearm could not distinguish inflammation from sarcoma. Frozen section during open biopsy revealed a granulomatous process and several budding yeasts. There was no evidence of a malignancy. Cultures of the tissue grew Blastomyces dermatitidis. The patient was treated successfully with surgical debridement of the mass and amphotericin B followed by itraconazole, for a total therapeutic course of 18 weeks. Although rarely diagnosed in children, blastomycosis must be included in the differential diagnosis of any soft tissue mass.

Amphotericin B↗
PubMed1994

[Cutaneopulmonary blastomycosis].

We observed a new case of blastomycosis in a patient with haemoptysis. The chest X-ray revealed a lesion confined to the upper right lobe of the lung and there was an ulcerating vegetation at the medial angle of the right eye. Skin biopsy and bronchial aspiration led to the identification of typical Blastomyces dermatitidis. Outcome was favourable after oral therapy with ketoconazole. Cutaneo-pulmonary blastomycosis is weakly endemic in Tunisia. Pulmonary lesions are more frequent because of airborne transmission. Cutaneous lesions may be clinically misleading. This disease is sensitive to antifungal imidazole derivatives.

Blastomycosis↗
PubMed1993

A clinician's view of blastomycosis.

In summary, blastomycosis is a rarely reported but important infection in certain endemic areas. Better understanding of the number with subclinical infection is dependent on studies with more reliable and specific immunologic testing. The illness may mimic several other conditions but particularly neoplastic disease. Therefore, fungal cultures and smears, which will allow a firm diagnosis, should be obtained during invasive procedures aimed at the diagnosis of cancer. Therapy of blastomycosis has been broadened with the addition of ketoconazole. Itraconazole appears to have even greater efficacy while fluconazole remains to be confirmed as an effective agent for this infection. The role of amphotericin B or itraconazole depends on comparative clinical trials.

Adult↗
PubMed1993

Gallium-67-citrate and bone scintigraphy in disseminated North American blastomycosis.

We present a patient with North American blastomycosis involving lung and bone. Chest radiographs and CT scan showed a mass in the lung. Bone scintigraphy detected a photon-deficient area in the sternum and 67Ga SPECT showed uptake in the right upper lung and in the sternum. A diagnostic thoracotomy and needle biopsy from the sternal lesion revealed granulomatous infection due to Blastomyces dermatitidis. After 3 mo of antifungal therapy, the follow-up 67Ga study showed no evidence of the original lesions but demonstrated a new, asymptomatic, unsuspected lesion in the left infraspinatous muscle. This case illustrates that North American blastomycosis should be included in the differential diagnosis in cases of atypical pulmonary disease with bone involvement, even in geographic regions that are not considered endemic for this microorganism. Gallium-67 and bone scintigraphy may be useful in determining the extent of dissemination, in detecting occult lesions and in the follow-up of response to therapy.

Adult↗
PubMed1997

Role of cell surface molecules of Blastomyces dermatitidis in the pathogenesis and immunobiology of blastomycosis.

The cell surface of pathogenic microbes is critical in directing their interactions with the host. The discovery of a 120 kd antigen/adhesin WI-1 on the yeast or parasitic form of Blastomyces dermatitidis has elucidated the molecular basis of host/pathogen interactions in blastomycosis. WI-1 has three structural domains: (1) an N-terminal hydrophobic domain that spans the cell membrane, (2) a C-terminal epidermal growth factor-like domain that may bind extracellular matrix, and (3) a central domain of many 24- or 25 amino-acid repeats arrayed in tandem. The repeat is homologous to invasin, a Yersinia adhesin, and binds CD11b/CD18 (CR3) and CD14 receptors on host cells. WI-1 expression is altered on genetically related strains of B dermatitidis differing in virulence and modulates how hypovirulent mutants interact with macrophages. WI-1 also evokes humoral and cell-mediated immune responses in acquired resistance to B dermatitidis that may help clear the fungus in the host. These observations on WI-1 provide new insight into a key pathogenic factor and antigen of the fungus and may ultimately help in designing new ways to diagnose, treat, and prevent blastomycosis.

Amino Acid Sequence↗
PubMed1997

Clinical features of blastomycosis.

Blastomycosis is a uncommonly diagnosed but important fungal infection in the south-central and midwestern United States. Epidemics related to a point-source exposure includes patients of all ages and both sexes, but endemic cases are usually in young to middle-aged adults, more reported commonly in men than women. The infection may mimic many other more common illnesses. Pneumonia is the most common manifestation, and the lung is almost always the organ initially infected. Infection in the lung may present either mimicking a short term bacterial pneumonia or a more indolent and long-term condition like tuberculosis or lung cancer. Cutaneous disease is the most common site of extrapulmonary involvement and may present with verrucous or ulcerative lesions. Osseous, prostatic, and central nervous system involvement are next most frequent in descending order. In a patient from the proper endemic area, blastomycosis should be on the differential diagnostic list for lung, skin, and other organ system infection.

Adult↗