Cheikh Rouhou Sana, Racil Hajer, Ismail Olfa, Trabelsi Sonia, Zarrouk Mourad, Chaouch Nawel, Hantous Sawssen, Khaled Samira, El Mezni Faouzi, Chabbou Abdellatif
Pulmonology Department, A.Mami Hospital, Ariana, Tunisia.
ScientificWorldJournal. 2008 Nov 2;8:1098-103. doi: 10.1100/tsw.2008.141.
Pulmonary blastomycosis is an uncommon pathologic condition that is quite rare in Africa compared to endemic regions of Canada and the upper Midwest of the U.S. We describe a 45-year-old patient who complained of productive cough, hemoptysis, and dorsal rachiodynia. Chest imaging revealed a necrotic tissue-density pulmonary mass involving both the upper and lower right lobes. Chest MRI showed signal abnormality of the third thoracic vertebral body and the greater trochanter, consistent with metastatic lesions. Clinical and radiological findings were strongly suggestive of lung cancer. Diagnosis of pulmonary blastomycosis was made by visualization of yeast in bronchial biopsies and further confirmed by culture of bronchoalveolar lavage specimens. The patient was treated with itraconazole and his clinical condition improved markedly. Pulmonary blastomycosis is unusual in Africa and that fact caused a considerable delay in diagnosis. We suggest that this disease may be more common in Africa than has been previously suspected.
肺芽生菌病是一种不常见的病理状况，与加拿大的流行地区及美国中西部上游地区相比，在非洲相当罕见。我们描述了一名45岁的患者，他主诉有咳痰、咯血和背部脊椎疼痛。胸部影像学检查发现一个坏死组织密度的肺部肿块，累及右下叶的上下部分。胸部磁共振成像显示第三胸椎椎体和大转子有信号异常，符合转移性病变。临床和放射学检查结果强烈提示为肺癌。通过在支气管活检中发现酵母样菌作出肺芽生菌病的诊断，并通过支气管肺泡灌洗标本培养进一步证实。该患者接受了伊曲康唑治疗，其临床状况明显改善。肺芽生菌病在非洲并不常见，这一事实导致了诊断的显著延迟。我们认为这种疾病在非洲可能比之前怀疑的更为常见。
