Extrapulmonary intrathoracic blastomycosis: a case report and systematic literature review

Abstract

Introduction: Mediastinal blastomycosis has been described in multiple case reports, but no review to date has catalogued its various manifestations or response to treatment. Case presentation: An otherwise healthy 18‐year‐old female presented with lymphadenopathy and was found to have a large mediastinal mass concerning for lymphoma. A subsequent biopsy revealed Blastomyces dermatitidis; the patient responded well to therapy with amphotericin B and itraconazole. Similar cases are reviewed and analysed. Conclusion: Mediastinal blastomycosis is a rare but life‐threatening disease manifestation that responds readily to appropriate antifungal therapy.

A Rare Case of Recurrent Blastomycosis in North America

“…It commonly occurs due to skin trauma leading to the introduction of fungus [6]. Skin is the most usual site (40-80%) of the dissemination of pulmonary (as seen in our case), followed by bone (10-50%), genitourinary tract (10-30%), and central nervous system (1-5%) [3,9]. The mortality is very high with central nervous system (CNS) involvement [3].…”

“…Blastomyces dermatitidis is a thermally dimorphic variety of fungus, depicting its mycelial form at room temperature and the yeast form at 37°C [9]. The isolation in the laboratory shows it in the mycelial phase incubated at 30°C.…”

Pleural Effusion in Pulmonary and Extrapulmonary Blastomycosis

“…The dimorphic fungus Blastomyces dermatitidis is endemic to the Great Lakes region and the Ohio and Mississippi River valley basins in the USA [1]. Blastomycosis was first recognized in Chicago in 1901 [2]. In the years since, it has remained endemic, with multiple outbreaks and an increasing incidence after 1990 [3].…”