Blastomycosis: Organ involvement and etiologic diagnosis. A review of 123 patients from Mississippi

Lemos, Luciano B.; Guo, Ming; Baliga, Mithra

doi:10.1053/adpa.2000.20755

Cited by 120 publications

(87 citation statements)

References 93 publications

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“…More frequently, pulmonary blastomycosis is diagnosed in cases of chronic pneumonia or when a lung neoplasia is suspected. In 20 to 40% of cases the disease has become systemic at the time of diagnosis and there is skin, soft tissue, bone, genitourinary (GU), or central nervous system involvement (9,87,99,118). In rare cases skin lesions without lung involvement have been described, suggesting direct cutaneous inoculation.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…1). The yeasts can be observed in a variety of specimens, including sputum, bronchoalveolar lavage (BAL) fluid, fine-needle aspirates from lung, skin, or other lesions, cerebrospinal fluid (CSF), and surgical resections (9,87). The thick refractile cell wall of this organism gives the appearance of a space between the fungal cell contents and the surrounding tissue when hematoxylin and eosin (H&E) stain is used.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…In addition, B. dermatitidis can be seen with a variety of routinely used preparations and stains such as KOH and Papanicolaou stain. The contour of the yeast is best highlighted by staining the cell wall with fungal silver stains such as GMS or periodic acid-Schiff (PAS) stain (87,118). The inflammatory reaction accompanying the yeasts is primarily granulomatous with various degrees of neutrophilic infiltrate; thus, it has been described as pyogranulomatous inflammation (118).…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

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Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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SUMMARY Fungal infections are becoming more frequent because of expansion of at-risk populations and the use of treatment modalities that permit longer survival of these patients. Because histopathologic examination of tissues detects fungal invasion of tissues and vessels as well as the host reaction to the fungus, it is and will remain an important tool to define the diagnostic significance of positive culture isolates or results from PCR testing. However, there are very few instances where the morphological characteristics of fungi are specific. Therefore, histopathologic diagnosis should be primarily descriptive of the fungus and should include the presence or absence of tissue invasion and the host reaction to the infection. The pathology report should also include a comment stating the most frequent fungi associated with that morphology as well as other possible fungi and parasites that should be considered in the differential diagnosis. Alternate techniques have been used to determine the specific agent present in the histopathologic specimen, including immunohistochemistry, in situ hybridization, and PCR. In addition, techniques such as laser microdissection will be useful to detect the now more frequently recognized dual fungal infections and the local environment in which this phenomenon occurs.

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Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

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Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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“…Aspergillus species can be seen by Gomori methenamine silver or periodic acid-Schiff (PAS) staining. Most tissue stains are inexpensive and can be performed easily in various specimens, such as sputum, BAL fluid, aspirates from lesions, cerebrospinal fluid (CSF), and other tissues (46,47). Fungi are identified based on size and morphological characteristics, which are generally nonspecific, thus allowing only for a descriptive diagnosis (48)(49)(50).…”

Section: Invasive Aspergillosismentioning

confidence: 99%

Molecular and Nonmolecular Diagnostic Methods for Invasive Fungal Infections

et al. 2014

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SUMMARY Invasive fungal infections constitute a serious threat to an ever-growing population of immunocompromised individuals and other individuals at risk. Traditional diagnostic methods, such as histopathology and culture, which are still considered the gold standards, have low sensitivity, which underscores the need for the development of new means of detecting fungal infectious agents. Indeed, novel serologic and molecular techniques have been developed and are currently under clinical evaluation. Tests like the galactomannan antigen test for aspergillosis and the β-glucan test for invasive Candida spp. and molds, as well as other antigen and antibody tests, for Cryptococcus spp., Pneumocystis spp., and dimorphic fungi, have already been established as important diagnostic approaches and are implemented in routine clinical practice. On the other hand, PCR and other molecular approaches, such as matrix-assisted laser desorption ionization (MALDI) and fluorescence in situ hybridization (FISH), have proved promising in clinical trials but still need to undergo standardization before their clinical use can become widespread. The purpose of this review is to highlight the different diagnostic approaches that are currently utilized or under development for invasive fungal infections and to identify their performance characteristics and the challenges associated with their use.

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“…At the University of Mississippi Medical Center, the first testing method for diagnosis was cytology in 58% of cases, KOH in 28% of cases, and histology in 12% of cases (8). The overall sensitivities were 93% for cytology, 85.1% for histology, 66.4% for culture, and 48.4% for KOH preparation.…”

mentioning

confidence: 99%

Antigen Assay with the Potential To Aid in Diagnosis of Blastomycosis

Durkin¹,

Witt²,

LeMonte³

et al. 2004

J Clin Microbiol

217

135

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We report results of an immunoassay for Blastomyces dermatitidis antigenuria. Sensitivity was 92.9%, and specificity was 79.3%. Cross-reactions occurred in 96.3% of patients with histoplasmosis, 100% of patients with paracoccidioidomycosis, 70% of patients with penicilliosis marneffei, 2.9% of patients with cryptococcosis, and 1.1% of patients with aspergillosis. Reproducibility was 96.3%. These findings support a potential role for antigen testing in blastomycosis.Most patients with blastomycosis exhibit progressive illnesses that require antifungal therapy. In one study, diagnosis was delayed for more than 1 month in nearly half of the cases (3). Blastomycosis was correctly suspected in only 20% of patients, resulting in unnecessary surgeries and treatment delays (7). In two-thirds of patients who died of acute respiratory distress syndrome caused by blastomycosis, the diagnosis was either not suspected or considered only after the patient became moribund (10).At the University of Mississippi Medical Center, the first testing method for diagnosis was cytology in 58% of cases, KOH in 28% of cases, and histology in 12% of cases (8). The overall sensitivities were 93% for cytology, 85.1% for histology, 66.4% for culture, and 48.4% for KOH preparation. Pathologists who are less experienced with morphological

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Blastomycosis: Organ involvement and etiologic diagnosis. A review of 123 patients from Mississippi

Cited by 120 publications

References 93 publications

Histopathologic Diagnosis of Fungal Infections in the 21st Century

Histopathologic Diagnosis of Fungal Infections in the 21st Century

Molecular and Nonmolecular Diagnostic Methods for Invasive Fungal Infections

Antigen Assay with the Potential To Aid in Diagnosis of Blastomycosis

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