The importance of skin exam in chronic pulmonary blastomycosis

Caldito, Elena Gonzalez; Flores, Estefanía; Antia, Camila; Demarais, Patricia

doi:10.1016/j.idcr.2020.e00812

Cited by 3 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These commonly progress to warty, verrucous plaques with heaped margins or, less often, lesions with central ulceration, abscesses, or violaceous nodules [ 58 , 59 ]. Severe cutaneous blastomycosis can expand to hundreds of lesions (typically not the scalp) and may also cause osteomyelitis by direct extension [ 47 , 58 , 59 ]. Mucus membranes are less commonly affected, though laryngeal, oral, and nasal lesions have been reported [ 60 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Skin is the most common site of extrapulmonary blastomycosis, typically presenting initially as papulopustular lesions. These commonly progress to warty, verrucous plaques with heaped margins or, less often, lesions with central ulceration, abscesses, or violaceous nodules [ 58 , 59 ]. Severe cutaneous blastomycosis can expand to hundreds of lesions (typically not the scalp) and may also cause osteomyelitis by direct extension [ 47 , 58 , 59 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Similar to the pulmonary form of blastomycosis, the cutaneous form is often misdiagnosed as malignancy (basal or squamous cell carcinoma); bacterial infection (tuberculosis); or other skin processes, such as pyoderma gangrenosum or keratoacanthoma [ 60 , 61 ]. Rarely, isolated cutaneous blastomycosis without concurrent pulmonary infection is thought to occur related to a resolved prior pulmonary infection or direct inoculation; these infections are usually more limited [ 59 , 62 ]. Figure 4 shows several different cutaneous presentations of blastomycosis.…”

Section: Clinical Presentationmentioning

confidence: 99%

See 2 more Smart Citations

Blastomycosis—Some Progress but Still Much to Learn

Pullen

Alpern

Bahr

2022

JoF

View full text Add to dashboard Cite

Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent, in India and the Middle East. Limited reporting inhibits our true understanding of the geographic distribution of blastomycosis. An estimated 50% of those infected remain asymptomatic. Of those who present with symptomatic disease, pulmonary involvement is most common, while the most common extrapulmonary sites are the skin, bones, genitourinary system, and central nervous system. Itraconazole is the standard therapy for mild–moderate disease. Data for other azoles are limited. Amphotericin is used for severe disease, and corticosteroids are occasionally used in severe disease, but evidence for this practice is limited. Despite increasing incidence and geographic reach in recent years, there are still significant knowledge gaps in our understanding of blastomycosis. Here, we provide an updated review of the epidemiology, clinical presentations, and diagnostic and therapeutic approaches for this infection. We also discuss areas needing further research.

show abstract

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

See 1 more Smart Citation

Blastomycosis—Some Progress but Still Much to Learn

Pullen

Alpern

Bahr

2022

JoF

View full text Add to dashboard Cite

show abstract

“…Blastomycosis, caused by Blastomyces dermatitidis, is a common endemic mycosis that occurs predominantly in North America including the northcentral, midwestern, and southern states of the United States [1]. The annual incidence of blastomycosis in the United States has been estimated at 1-40 cases per 100,000; however, as only a few states report it, the true annual incidence remains unknown [2]. The primary infection mainly involves the lungs.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Blastomycosis Mimicking Breast Malignancy

Chisenga

Chatterjee

Erbowor-Becksen

et al. 2021

Cureus

View full text Add to dashboard Cite

Blastomycosis is a fungal infection caused by Blastomyces dermatitidis. While blastomycosis can cause systemic infection affecting multiple organs, localized blastomycosis of the breast is uncommon. Here, we report the case of a 50-year-old female with a localized left breast growth which started as a nodule and later ulcerated extensively. Although her clinical picture raised concerns for breast malignancy, workup revealed cutaneous blastomycosis with superimposed methicillin-susceptible Staphylococcus aureus and Klebsiella oxytoca infection. Interestingly, there was no evidence of pulmonary disease on CT chest imaging. She was treated with Amphotericin B for seven days and discharged on oral Itraconazole for nine months. Additionally, she received amoxicillin-clavulanate for her bacterial superinfection. On the six-month followup, the patient showed significant improvement. Blastomycosis can mimic several diseases including malignancy, pyoderma gangrenosum, and mycobacterial and bacterial infections leading to delayed diagnosis and treatment.

show abstract