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PubMedDate not supplied

Identification of Blastomyces dermatitidis in the stool of a dog with acute pulmonary blastomycosis.

We report the identification of Blastomyces dermatitidis by microscopic examination of a direct faecal smear from a dog with pulmonary blastomycosis. A simultaneously obtained faecal culture grew Blastomyces dermatitidis. The fungus was also cultured from a transtracheal sample from this same dog. This report suggests that yeast-phase cells of B. dermatitidis may be recovered in the stool of dogs with pulmonary blastomycosis following transit through the gastrointestinal tract of swallowed infected sputum. Implications regarding the ecology of Blastomyces dermatitidis are discussed.

Animals↗
PubMedDate not supplied

Cutaneous blastomycosis. Report of a case with diagnosis by fine needle aspiration cytology.

BACKGROUND: Blastomycosis is rare in India. Clinically, cutaneous blastomycosis may be mistaken for keratoacanthoma, squamous cell carcinoma, tuberculosis, tertiary syphilis, leprosy or pyoderma. CASE: A 19-year-old male presented with a soft, fluctuant swelling at the medial canthus of the eye. Fine needle aspiration biopsy (FNAB) showed many single, spherical structures with thick walls. They had basophilic protoplasm and six nuclei in the center. A few of them showed budding with a broad base. CONCLUSION: The cytomorphology of Blastomyces dermatitidis is characteristic, and the organism can be differentiated from other yeast forms. The disease is sensitive to antifungal imidazole derivatives and can be cured.

Adult↗
PubMed1978

Central nervous system involvement in South American blastomycosis.

The authors present a patient with South American blastomycosis with cerebral involvement in whom a ventriculography and a cerebral arteriography showed a tumour at the level of the fourth ventricle. After six months of therapy, clinical cure of some lesions was obtained while the neurological picture of right hemiparesia remained unchanged. Surgery was performed and the histopathological study revealed a tuberculoid, granuloma-forming gumma. The literature is reviewed and comments are made on the cerebro-spinal fluid changes and the types of involvement of the nervous system. The neurological examination and the analysis of the cerebro-spinal fluid indicated that the relative frequency of central nervous system localization in South American blastomycosis was not in agreement with current thought.

Adult↗
PubMed1993

Blastomycosis of the skull base.

Blastomycosis is usually considered a pulmonary or cutaneous disease. A patient with blastomycosis of the infratemporal fossa temporal bone and sinuses without pulmonary disease is presented. Extensive skull base involvement required surgical debridement for relief of pain, and long-term systemic antifungal therapy. The literature is reviewed and discussed.

Journal Article↗
PubMed2001

[South American blastomycosis--a differential diagnosis to tuberculous meningitis].

BACKGROUND: South American blastomycosis is primarily a lung infection often complicated by multiorgan or intracranial disease. MATERIAL AND METHODS: We describe the clinical and pathological findings of fatal cerebral blastomycosis occurring in a woman that immigrated to Norway from Brazil 23 years earlier. RESULTS: The clinical symptoms together with the radiological findings of multiple cerebral lesions and thickening of the basal meninges were interpreted as cerebral tuberculosis. Examination of cerebral spinal fluid was inconclusive. A diagnosis of cerebral fungal infection was subsequently established by brain biopsy. INTERPRETATION: This case history stresses the importance of confirming a clinical diagnosis by brain biopsy and extended investigation of the cerebrospinal fluid when intracranial lesions may have an infectious origin.

Diagnosis, Differential↗
PubMedDate not supplied

Obstructive jaundice caused by blastomycosis of the lymph nodes around the common bile duct.

A case of obstructive jaundice due to granulomatous blastomycosis is presented. The patient had complained of abdominal pain in the right hypochondrium and jaundice. During hospitalization, the laboratory tests showed evidence of obstructive jaundice and complementary tests a distended gallbladder, dilatation of the intra and extrahepatic bile ducts with enlarged lymph nodes of the hepatic hilus. During the operation a cholestatic liver, distended gallbladder and enlarged lymph nodes around the common bile duct were found. Histopathology of the lymph nodes revealed South American blastomycosis. The medical management consisted of amphotericin B. At present the patient is alive and well.

Adult↗
PubMed1986

Blastomycosis of the eyelid.

An 84-year-old man had a verrucous lesion of the left lower eyelid that caused progressive ectropion. Cultures of the lesion taken at the time of surgical excision demonstrated Blastomyces dermatitidis. Histologically, the excised tissue demonstrated pseudoepitheliomatous hyperplasia, a characteristic change of cutaneous blastomycosis.

Aged↗
PubMed1988

Latent disseminated blastomycosis with choroidal involvement.

A 36-year-old man developed blurred vision and a cough five months after traveling to an area from where a large outbreak of acute blastomycosis had been reported. Examination revealed a left choroidal lesion in the macular region, skin lesions on the right calf, and a left lung apical infiltrate. Histopathologic examination of the skin lesion demonstrated a granulomatous inflammation and broad based, budding yeast characteristic of Blastomyces dermatitidis. Amphotericin B therapy produced a rapid resolution of both choroidal and pulmonary lesions. During a six-month follow-up, there was no evidence of recurrence.

Adult↗
PubMed1991

Fulminant blastomycosis with blastomycotic infection of a cerebral glioma. Light microscopic and ultrastructural observations.

Except for isolated case reports, blastomycosis has not been identified as a significant problem in immunosuppressed patients. We describe an unusual case with blastomycotic infection of a cerebral glioma in a 56-year-old man who underwent radiotherapy for his tumor and died of fulminant blastomycotic pneumonia. This is believed to be the first reported case of Blastomyces dermatitidis infection of a cerebral glioma. The light microscopic and ultrastructural features of B. dermatitidis, the giant forms of which were encountered in our patient, are described, and thr role of immunosuppression due to steroid therapy in the pathogenesis of this fulminant infection are reviewed.

Blastomyces↗
PubMed1983

Immunostimulation with muramyl dipeptide and its desmethyl analogue: Studies of non-specific resistance to pulmonary blastomycosis in inbred mouse strains.

N-acetyl-muramyl-L-alanyl-D-isoglutamine (MDP) protected against pulmonary blastomycosis when given prophylactically to BALB/c mice. Its desmethyl analogue (DM-MDP) had a similar effect. In C3H/HeJ, the effect was less marked. Early treatment after infection, with MDP and DM-MDP, had a modest effect in C3H/HeJ and BALB/c respectively, whereas late treatment had no effect in any mouse strain. No effect could be demonstrated with challenge sizes producing too lethal a model or minimal lethality, or in DBA/2J or young BALB/c mice. The effects in various strains do not correlate with differing effects on nonspecific immunostimulation in these strains. Immunostimulation with glycopeptides deserves further study in prophylaxis or therapy of fungal infection.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1982

Blastomycosis: report of the first case from Alberta Canada.

The first known case of laboratory confirmed blastomycosis in Alberta occurred in 1970. The patient, who is believed never to have left Alberta, presented with of headaches, sore neck and impaired intellect. Initially, tuberculous or cryptococcal meningitis was suspected, but laboratory findings did not support the diagnosis. A fungus resembling Blastomyces dermatitidis was isolated from the venticular cerebrospinal fluid and lung at autopsy. A few yeast cells suggestive of B. dermatitidis were seen in lung and brain tissue sections. Initial attempts at in vitro conversion of the mycelial form of the isolate into yeast form on several enriched media were unsuccessful. The fungus gave +/- to ++ reactions B. dermatitidis specific conjugate by the direct fluorescent antibody technique, it was not pathogenic for mice and guinea pigs, and no asexual spores were produced in slide cultures. Further investigation indicated that the mycelial form of the fungus converted into its yeast form when an actively growing inoculum was used, although the yeast cells varied considerably in size. The yeast form produced disseminated infection in mice within 10 days. Exoantigenic analysis demonstrated an 'A' antigen specific for B. dermatitidis, which revealed the identity of this organism as an atypical strain of B. dermatitidis.

Animals↗
PubMed1977

Blastomycosis: specificity of antigens reflecting the mating types of Ajellomyces dermatitidis.

In a study of sera from patients with proven or suspected blastomycosis, positive immunodiffusion tests were obtained in all active cases when fresh sera were tested with a cell sap (CS) antigen. False negatives occurred on occasion when an ethanol precipitate (EPF) antigen was used alone. No false positives were found. The CS antigen from the (+) mating type had in common two lines of identity with the (CS) antigen of the (-) type. In addition, other lines were present when the patient was infected with the same mating type as was used for the preparation of the antigen. No differences in the electrophoretic patterns of the enzymes leucine amino peptidase or phosphatase were noted when preparations from the two mating types were compared. However, a distinct pattern was noted when the alpha esterases of the (+) and (-) mating types were examined. Specific alpha esterase antibodies were present in patients' sera.

Antigens, Fungal↗
PubMed1995

Cytologic findings in 43 cases of blastomycosis diagnosed ante-mortem in naturally-infected dogs.

A retrospective study of the cytology of blastomycosis was undertaken. Sixty-one samples from 43 naturally infected dogs diagnosed ante-mortem by means of cytology were reviewed. Skin and lymph nodes rendered the highest number of positive samples with 17 out of 18 and 14 out of 17 respectively. Transtracheal washes contained the tissue forms of Blastomyces dermatitidis in 3 out of 5 samples. Pyogranulomatous inflammation was diagnosed in 38 of the 61 samples, and of these, 25 cases contained multinucleated giant cells. Epithelioid cells were found in all 38 cases. Purulent inflammation was seen in 15 out of 61 samples. Three cases had a minimal or virtual lack of inflammation. The cytologic findings are described and photographically illustrated.

Animals↗
PubMed2005

Blastomyces dermatitidis antigen detection in urine specimens from dogs with blastomycosis using a competitive binding inhibition ELISA.

A competitive binding inhibition enzyme linked immunosorbent assay (ELISA) was used to detect Blastomyces dermatitidis antigens in urine specimens from dogs with blastomycosis. Sera from rabbits immunized with B. dermatitidis killed whole yeast cells were used as the primary antibody in the competitive ELISA. This initial study was performed to determine if B. dermatitidis antigen detection was possible and to test the efficacy of the rabbit sera as a primary antibody. An indirect ELISA was also performed to compare antigen detection in urine to antibody detection in the sera of the infected dogs. The results indicate 100% (36/36 specimens) detection of both antigen and antibody. Cross reactivity with Histoplasma capsulatum, as well as non-specific binding with the normal urine specimens, was observed with the competitive binding inhibition ELISA.

Animals↗
PubMed1978

The association of adenocarcinoma of the lung and blastomycosis from an unusual geographical location.

A case of North American blastomycosis acquired outside the American continent and presenting with a left hilar mass is reported. The progressive hilar enlargement, despite adequate antifungal treatment, raised the possibility of drug resistance, concomitant tuberculosis and carcinoma. Non-invasive diagnostic studies including cultures, cytology and fibreoptic bronchoscopy were negative. On thoracotomy, both blastomy cosis and a poorly undifferentiated adenocarcinoma were evident.

Adenocarcinoma↗
PubMed1987

Microscopic lesions of spontaneous ocular blastomycosis in dogs.

Ocular tissues from 13 dogs with naturally-occurring blastomycosis were examined histologically. Choroiditis and separation of the sensory retina from its epithelium were the most prominent lesions, although all three coats of the eye were always involved. Severe panophthalmitis was associated with a marked exudative reaction within the ocular tissues. Whereas inflammation of the anterior ocular tissues was often intense, it was rarely associated with the presence of B. dermatitidis. Sequelae to the ocular inflammation included cataract, synechiae, rubeosis iridis, and closure of the drainage angle. The last of these resulted in glaucoma and resulting degeneration of the optic nerve.

Animals↗
PubMed1982

Localized oral blastomycosis mimicking actinomycosis.

A case of blastomycosis limited to the oral cavity is presented. The disease apparently originated in the mandible and eroded into the oral cavity. Secondary bacterial infection of the sinus tracts resulted in a clinical picture that mimicked cervicofacial actinomycosis. Appropriate microbiologic studies, including culture confirmation of the causative organism, were necessary to establish a definitive diagnosis.

Actinomycosis, Cervicofacial↗