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Blastomycosis, Thoracic: Follow-up

Author: Fahad M Alhameed, MD, AmBIM, FCCP, FRCPC, Deputy Chairman of Intensive Care Department, Consultant Critical Care and Pulmonary Medicine, Department of Intensive Care and Pulmonary Medicine, King Khalid National Guard Hospital, Jeddah, Saudi Arabia
Coauthor(s): Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St. Boniface General Hospital; Bruce Maycher, MD, Director of Pulmonary Radiology, St Boniface General Hospital; Associate Professor, Department of Radiology, University of Manitoba
Contributor Information and Disclosures

Updated: Oct 17, 2008

Intervention

Before the availability of chemotherapy for the treatment of blastomycosis, the disease was reported to have a progressive course, with the eventual development of extrapulmonary disease; the mortality rate exceeded 60%. After the introduction of effective antifungal therapy, it became accepted practice to treat all blastomycosis patients, especially those with symptoms.

Medicolegal Pitfalls

  • Failure to maintain a high index of suspicion may lead to misdiagnosis or a delay in diagnosis. An inadequate review of the patient's occupation, travel history, and region of habitation may result in misdiagnosis. Because radiographic findings are nonspecific, the diagnosis commonly is delayed.
  • Failure to initiate treatment promptly results in higher morbidity and mortality rates
 


More on Blastomycosis, Thoracic

Overview: Blastomycosis, Thoracic
Imaging: Blastomycosis, Thoracic
Follow-up: Blastomycosis, Thoracic
Multimedia: Blastomycosis, Thoracic
References
Further Reading
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References

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  2. Bradsher RW Jr. Pulmonary blastomycosis. Semin Respir Crit Care Med. Apr 2008;29(2):174-81. [Medline].

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  4. Bialek R, González GM, Begerow D, Zelck UE. Coccidioidomycosis and blastomycosis: advances in molecular diagnosis. FEMS Immunol Med Microbiol. Sep 1 2005;45(3):355-60. [Medline].

  5. Taxy JB. Blastomycosis: contributions of morphology to diagnosis: a surgical pathology, cytopathology, and autopsy pathology study. Am J Surg Pathol. Apr 2007;31(4):615-23. [Medline].

  6. CDC. Blastomycosis--Wisconsin, 1986-1995. From the Centers for Disease Control and Prevention. JAMA. Aug 14 1996;276(6):444. [Medline].

  7. Wisconsin Department of Health Services. RARE FUNGAL INFECTION CAN GO UNDIAGNOSED. Last revised Sept. 12, 2008. Wisconsin Department of Health Services. Available at http://dhs.wisconsin.gov/News/PressReleases/2008/091208Blasto.htm. Accessed October 17, 2008.

  8. Baily GG, Robertson VJ, Neill P, et al. Blastomycosis in Africa: clinical features, diagnosis, and treatment. Rev Infect Dis. Sep-Oct 1991;13(5):1005-8. [Medline].

  9. DiSalvo AF. The ecology of Blastomyces dermatiridis. In: Al-Doory Y, DiSalvo AF, eds. Blastomycosis. Kluwer Academic Pub;1992:43.

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  11. Bruce Light R, Kralt D, Embil JM, Trepman E, Wiebe L, Limerick B, et al. Seasonal variations in the clinical presentation of pulmonary and extrapulmonary blastomycosis. Med Mycol. Jul 24 2008;1-7. [Medline].

  12. Neuzil KM, Mitchell HC, Loyd JE, et al. Extrapulmonary thoracic disease caused by Blastomyces dermatitidis. Chest. Dec 1994;106(6):1885-7. [Medline].

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  23. Lagging LM, Breland CM, Kennedy DJ, et al. Delayed treatment of pulmonary blastomycosis causing vertebral osteomyelitis, paraspinal abscess, and spinal cord compression. Scand J Infect Dis. 1994;26(1):111-5. [Medline].

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Further Reading

Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America.
Infectious Diseases Society of America.  2000 Apr (revised 2008 Jun 15).  12 pages.  NGC:006497

Coccidioidomycosis.
Infectious Diseases Society of America.  2000 Apr (revised 2005 Nov 1).  7 pages.  NGC:004563 

Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America.
Infectious Diseases Society of America.  2000 Apr (revised 2007 Oct).  19 pages.  NGC:005950 
 

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Keywords

blastomycosis, thoracic blastomycosis, Blastomyces dermatitidis, pulmonary blastomycosis, disseminated blastomycosis, blastomycetoma, blastocytoma, Gilchrist disease, mycosis, mycoses

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Contributor Information and Disclosures

Author

Fahad M Alhameed, MD, AmBIM, FCCP, FRCPC, Deputy Chairman of Intensive Care Department, Consultant Critical Care and Pulmonary Medicine, Department of Intensive Care and Pulmonary Medicine, King Khalid National Guard Hospital, Jeddah, Saudi Arabia
Fahad M Alhameed, MD, AmBIM, FCCP, FRCPC is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, Canadian Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St. Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Disclosure: Nothing to disclose.

Bruce Maycher, MD, Director of Pulmonary Radiology, St Boniface General Hospital; Associate Professor, Department of Radiology, University of Manitoba
Bruce Maycher, MD is a member of the following medical societies: American Roentgen Ray Society, Canadian Medical Association, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

Medical Editor

Satinder P Singh, MD, Associate Professor of Radiology, Chief of Cardiopulmonary Radiology, Director of Cardiac CT, Director of Combined Cardiopulmonary and Abdominal Radiology, Department of Radiology, University of Alabama at Birmingham
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Eric J Stern, MD, Professor of Radiology, Adjunct Professor of Medicine, Adjunct Professor of Medical Education and Biomedical Informatics, University of Washington School of Medicine; Director of Thoracic Imaging, Harborview Medical Center; Associate Medical Staff, Seattle Cancer Care Alliance
Eric J Stern, MD is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, European Society of Radiology, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Clinical Assistant Professor of Radiology, University of Washington Medical School
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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