Non-resolving Community Acquired Pneumonia (CAP) due to Blastomyces dermatitidis (Pulmonary Blastomycosis): Case Report and Review of Literature

Abstract

Initial diagnostic laboratory work up showed leucocyte count of 14,500 cells/mm 3 (76% segmented neutrophils, 13% lymphocytes and 11% monocytes), hemoglobin 12.9 g/dl, hematocrit 38.9% and platelet count 316,000/mm 3. Serum electrolytes, renal function, and liver function tests were normal. Rapid Influenza test was positive for Influenza A. Urine streptococcal and legionella antigens were negative. Chest X-ray (CXR) showed an ovoid superior segment left lower lobe focus of consolidation (Figure 1). A diagnosis of Influenza A and possible community acquired bacterial pneumonia was made and patient was admitted to the hospital. She was started on oral oseltamivir and intravenous ceftriaxone and azithromycin.