Primary Blastomycosis of Oral Cavity

Kruse, Astrid L; Zwahlen, Roger A.; Bredell, Marius; Gengler, Carole; Dannemann, Christine; Grätz, Klaus W.

doi:10.1097/scs.0b013e3181c4680c

Cited by 15 publications

(7 citation statements)

References 16 publications

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“…12 Particular concern should be paid to bleeding from non-healing tooth sockets following extraction, which can indicate an underlying malignancy, especially in the presence of pain over the area affected. 12 Particular concern should be paid to bleeding from non-healing tooth sockets following extraction, which can indicate an underlying malignancy, especially in the presence of pain over the area affected.…”

Section: Discussionmentioning

confidence: 99%

Evidenced-based management of haemoptysis by otolaryngologists

Bannister

Ah‐See

2015

J. Laryngol. Otol.

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Section: Discussionmentioning

confidence: 99%

Evidenced-based management of haemoptysis by otolaryngologists

Bannister

Ah‐See

2015

J. Laryngol. Otol.

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“…In one reported case, a patient with an abnormal mammogram and computerized CT was initially mistaken to have breast carcinoma with metastasis to the spine [4]. In another case, a patient with cutaneous symptoms (but without pulmonary symptoms) was misdiagnosed with having squamous cell carcinoma [9].…”

Section: Differential Diagnosesmentioning

confidence: 99%

A Curious Case of Blastomyces Osteomyelitis

Sapra

Pham

Ranjit

et al. 2020

Cureus

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Blastomycosis is an uncommon disease caused by the dimorphic fungus, Blastomyces dermatitidis, often found in endemic regions of Midwestern America. It can be found in forested, sandy soils, decaying vegetation, rotting wood near water sources, and even in bird feces. Most commonly, blastomycosis manifests as a pulmonary infection presenting as pneumonia, or in severe cases, respiratory distress syndrome (ARDS). Dissemination to the bone is less common but osteomyelitis of the lower thoracic and lumbar spine, ribs, skull, and long bones have been most frequently reported. Disseminated infection to the genitourinary system commonly manifests as prostatitis or epididymo-orchitis in men and as an endometrial infection or tubo-ovarian abscess in women. In the nervous system, blastomycosis can manifest as meningitis or with a cranial abscess. Having a high degree of clinical suspicion and obtaining a detailed medical and social history is important for making a diagnosis. Culturing a specimen will provide a definitive diagnosis. Sputum or tissue specimens stained in 10% potassium hydroxide under microscopy will reveal the classic appearance of B. dermatitidis (broad-based budding with a double-contoured cell wall). In mild to moderate disease without dissemination, itraconazole is the treatment of choice. In severe, life-threatening cases, patients with CNS involvement or in immunocompromised individuals, amphotericin B is the preferred initial drug of choice. We present an interesting case of a 42-year-old African-American male with no significant past medical history who was admitted initially for suspicion of cellulitis/septic arthritis and was started on broad-spectrum antibiotics. However, he was eventually found to have Blastomyces osteomyelitis.

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“…1 The most common sites of dissemination to the head and neck region include the skin, larynx, oral and nasal mucosa, and thyroid. [2][3][4][5] Blastomyces dermatitidis is endemic to the Ohio River and Mississippi River basins of North America as well as to watershed areas that border the Great Lakes, including Canada. 1 Hyperendemic areas include Wisconsin, where our patient lived.…”

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“…5 Oral and nasal mucosal involvement may mimic squamous cell carcinoma, with indurated tissue and leukoplakia on gross examination. 4 In the few reported cases of thyroid involvement, blastomycosis presented as a thyroid mass with evidence of nonnecrotizing granulomatous inflammation seen on a fine-needle aspirate. 3 Definitive diagnosis of blastomycosis is the pathognomonic appearance of broad-based buds of multinucleate yeast on specimens obtained at the specific site of disease presentation.…”

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confidence: 99%

“…When present in tissue lined by squamous cell epithelium, blastomycosis infection is known to induce pseudoepitheliomatous hyperplasia and acantholysis. 1,2,4,5 In the lungs, bronchial washings, followed by sputum samples, have the highest diagnostic yield. 8 For cutaneous lesions, it is recommended that the sample include the entire depth and that it be obtained from the diseased edge with a fine-needle biopsy or skin scrapings of exudate.…”

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confidence: 99%

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