Chronic Pulmonary Blastomycosis Mimicking Pulmonary Tuberculosis

Koroscil, Matthew; Skabelund, Andrew

doi:10.1093/milmed/usx122

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…They are frequently multiple, usually well circumscribed and begin as papulopustular lesions that progress to verrucous, ulcerated or crusted lesions. Violaceous nodules and abscesses can also occur [46][47][48]50].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Miliary or reticulonodular patterns and pleural effusion are also reported. Cavitary disease and lymphadenopathy can occur but are uncommon when compared with tuberculosis and chronic pulmonary histoplasmosis [50,52].…”

Section: Imaging Manifestationsmentioning

confidence: 99%

“…Special stains such as periodic acid-Schiff and Gomorimethenamine silver are helpful to the diagnosis. Surrounding tissue reveals noncaseating granulomas with epithelioid cells[49,50].…”

mentioning

confidence: 99%

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Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging

Mango

Zanetti

Penha

et al. 2019

Expert Review of Respiratory Medicine

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Introduction: Systemic endemic mycoses are prevalent in specific geographical areas of the world and are responsible for high rates of morbidity and mortality in these populations, and in immigrants and travelers returning from endemic regions. The most common fungal infections that can affect the lungs of immunocompetent patients include histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, aspergillosis, and cryptococcosis. Diagnosis and management of these diseases remain challenging, especially in non-endemic areas due to the lack of experience. Therefore, recognition of the various radiologic manifestations of pulmonary fungal infections associated with patients' clinical and epidemiologic history is imperative for narrowing the differential diagnosis. Areas covered: This review discusses the clinical and radiological findings of the main endemic fungal diseases affecting the lungs in immunocompetent patients. Specific topics discussed are their etiology, epidemiology, pathogenesis, clinical manifestations, methods of diagnosis, pathology and main imaging findings, especially in computed tomography. Expert commentary: Imaging plays an important role in the diagnosis and management of pulmonary fungal infection and may reveal useful signs. Although definitive diagnosis cannot be made based on imaging features alone, the use of a combination of epidemiologic, clinical and imaging findings may permit the formulation of an adequate differential diagnosis.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Imaging Manifestationsmentioning

confidence: 99%

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Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging

Mango

Zanetti

Penha

et al. 2019

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…Chronic pulmonary blastomycosis results in chronic cough, weight loss, and hemoptysis, often masquerading as TB or malignancy ( 4 ). The patient described here exemplifies the challenges of diagnosing pulmonary blastomycosis in a non–blastomycosis-endemic area where TB is prevalent.…”

mentioning

confidence: 99%

“…Most patients receive multiple courses of anti-TB treatment, which can delay blastomycosis diagnosis by >1 month ( 5 ). Chronic pulmonary blastomycosis has been misdiagnosed and treated as TB in disease-endemic and non–disease-endemic areas ( 1 , 4 ). Even in blastomycosis-endemic areas such as Illinois, the median time from onset to diagnosis is 128 days (range 12–489 days) ( 6 ).…”

mentioning

confidence: 99%