Pulmonary blastomycosis masquerading as metastatic disease in the lung: a case report.
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We report a case of pulmonary blastomycosis appearing as metastatic laryngeal squamous cell carcinoma. Pulmonary blastomycosis was discovered as right lower lobe subpleural activity consistent with metastatic disease on a positron emission tomographic (PET) scan following total laryngectomy and bilateral neck dissection for locally invasive laryngeal squamous cell carcinoma. A computed tomographic (CT) scan of the chest showed a right lower lobe, subpleural pulmonary nodule. CT-guided fine-needle aspiration of the nodule revealed broad-based budding yeast consistent with blastomycosis. To our knowledge, this is the first case of a PET-positive pulmonary blastomycosis lesion mimicking pulmonary malignancy reported in the literature. (+info)
Mixed pulmonary infection with Strongyloides stercoralis and Blastomyces dermatitidis.
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We report the first case of mixed pulmonary infection with Strongyloides stercoralis and Blastomyces dermatitidis. Histopathology from the lung biopsy showed structures consistent with B. dermatitidis and S. stercoralis. A parasitology exam from a bronchi alveolar lavage yielded an immature rhabditiform larva and female worm. Fungal cultures grew B. dermatitidis. (+info)
Human and canine pulmonary blastomycosis, North Carolina, 2001-2002.
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We investigated a cluster of blastomycosis in 8 humans and 4 dogs in a rural North Carolina community. Delayed diagnosis, difficulty isolating Blastomyces dermatitidis in nature, and lack of a sensitive and specific test to assess exposure make outbreaks of this disease difficult to study. (+info)
V beta1+ J beta1.1+/V alpha2+ J alpha49+ CD4+ T cells mediate resistance against infection with Blastomyces dermatitidis.
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Immunization with a cell wall/membrane (CW/M) and yeast cytosol extract (YCE) crude antigen from Blastomyces dermatitidis confers T-cell-mediated resistance against lethal experimental infection in mice. We isolated and characterized T cells that recognize components of these protective antigens and mediate protection. CD4+ T-cell clones elicited with CW/M antigen adoptively transferred protective immunity when they expressed a V alpha2+ J alpha49+/V beta1+ J beta1.1+ heterodimeric T-cell receptor (TCR) and produced high levels of gamma interferon (IFN-gamma). In contrast, V beta8.1/8.2+ CD4+ T-cell clones that were reactive against CW/M and YCE antigens and produced little or no IFN-gamma either failed to mediate protection or exacerbated the infection depending on the level of interleukin-5 expression. Thus, the outgrowth of protective T-cell clones against immunodominant antigens of B. dermatitidis is biased by a combination of the TCR repertoire and Th1 cytokine production. (+info)
Northern Wisconsin married couple infected with blastomycosis.
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Blastomycosis is an uncommon, chronic, granulomatous disease caused by the dimorphic fungus Blastomycosis dermatitidis. The great majority of infections start with primary pulmonary involvement through inhalation of spores. Hematogenous dissemination to other sites occurs in 25% to 30% of cases. The most common secondary site is the skin, followed in order by bone, genitourinary system, and central venous system. We report 2 cases of blastomycosis originating in a husband and wife who were both symptomatic and diagnosed with blastomycosis within 4 months of each other. One presented with pulmonary symptoms, the other with cutaneous symptoms. These 2 cases of husband and wife are of interest not only because of their rarity but also because of the potential mode of transmission. (+info)
Systemic blastomycosis in a horse.
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Progressive multisystemic disease caused by Blastomyces dermatitidis was diagnosed in a 17-year-old Quarter horse broodmare. The mare had been treated unsuccessfully with antibiotics for mastitis 3 months postpartum. The disease progressed to exudative cutaneous lesions affecting the ventrum, pectoral region, and limbs accompanied by weight loss across several months. Yeast bodies were observed in swabs of the cutaneous exudate, suggesting a clinical diagnosis of blastomycosis. Following referral, pleural effusion, cavitated lung lesions, and hyperproteinemia were identified, and the mare was euthanized because of poor prognosis. Necropsy revealed extensive pyogranulomas in the mammary gland, skin, subcutaneous tissues, and lungs, accompanied by thrombi in major blood vessels of the lungs and hind limbs. Histologically, pyogranulomatous inflammation was evident in many tissues, and fungal organisms were seen in sections of mammary gland, skin, subcutis, pericardium, and lung. Blastomyces dermatitidis was cultured from mammary tissue, lungs, lymph node, and an inguinal abscess. Although blastomycosis is endemic in the area of origin of the mare in northwestern Wisconsin, the disease is extremely rare in horses and hence easily misdiagnosed. Unique features of this case included the extent of mammary gland involvement and the presence of thrombi in multiple sites. (+info)
Blastomycosis in a young African man presenting with a pleural effusion.
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Blastomyces dermatitidis is a dimorphic fungus endemic to north-western Ontario, Manitoba and some parts of the United States. The fungus is also endemic to parts of Africa. Pulmonary and extrapulmonary findings of a 24-year-old African man who presented with weight loss, dry cough and chronic pneumonia not resolving with antibiotic treatment are presented. The unusual occurrence of pulmonary blastomycosis associated with skin lesions and a moderate pleural effusion is reported. (+info)
43-kilodalton glycoprotein from Paracoccidioides brasiliensis: immunochemical reactions with sera from patients with paracoccidioidomycosis, histoplasmosis, or Jorge Lobo's disease.
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Sera from patients with paracoccidioidomycosis (PCM), histoplasmosis (HP), or Jorge Lobo's disease (JL) were titrated against purified gp43 from Paracoccidioides brasiliensis by using both enzyme-linked immunosorbent assay (ELISA) and immunoprecipitation (IPP) reactions with 125I-labeled antigens. In IPP, PCM sera and other sera could be distinguished on the basis of serum titers, whereas in ELISA, 53% of the HP sera and 29% of the JL sera reacted similarly to the PCM sera. To investigate the possible role of the carbohydrate epitopes in these reactions, we compared the reactivities of sera from several patients with native and deglycosylated gp43. Competition experiments were carried out with monosaccharides as inhibitors. The results suggest that greater than 85% of the reactions of the PCM sera with gp43 involved peptide epitopes. Cross-reactions with HP and JL sera in ELISA were predominantly attributed to periodate-sensitive carbohydrate epitopes containing galactosyl residues. HP and JL sera which reacted strongly with gp43 in ELISA were only weakly reactive or did not react in IPP with labeled antigens in solution. Moreover, ELISA reactions could be significantly inhibited either by monosaccharides or by periodate treatment. Apparently, carbohydrate epitopes in gp43 are more accessible to the antibodies when the molecule is bound to a plastic substrate than when it is in solution. Structural changes in the gp43 antigen arising by N deglycosylation abolish reactivity with PCM sera and support the existence of conformational peptide epitopes. (+info)