Rais H, Jghaimi F, Baalal H, Naji Y, Essaadouni L, Essadki O, Oussehal A, Mejjati M, Aitbenali S, Elyazidi A Alaoui, Belaabidia B
Service d'anatomie pathologie, faculté de médecine et de pharmacie, CHU Mohammed VI, université Cadi Ayyad, Marrakech, Maroc.
Rev Pneumol Clin. 2012 Feb;68(1):45-9. doi: 10.1016/j.pneumo.2011.04.006. Epub 2011 Jul 16.
Blastomycosis is a rare case. We report a first Moroccan case. A 41-year-old male presented with a 6-month history of dyspnea, fever and significant chest pain associated with night sweats and weight loss. The physical examination disclosed a firm painful paravertebral mass. The chest radiograph demonstrated a left apical opacity. The thoracic scan showed parenchymal infiltration of the apico-dorsal segment of the left upper lobe with vertebral and costal lytic lesions. Surgical biopsy showed granulomatous inflammation with giant-cell intracytoplasmic inclusions. Fungal studies yielded Blastomyces dermatitidis which responded excellently to ketoconazole. Outcome has been excellent at 3.5 years months follow-up. The clinical and radiographic presentation of blastomycosis is non-specific and can be mistaken for a neoplasm. Delay in diagnosis is common.
芽生菌病是一种罕见病例。我们报告首例摩洛哥病例。一名41岁男性，有6个月的呼吸困难、发热病史，伴有严重胸痛，同时伴有盗汗和体重减轻。体格检查发现一个坚硬且有压痛的椎旁肿块。胸部X线片显示左肺尖部有不透明影。胸部扫描显示左上叶尖后段实质浸润，伴有椎体和肋骨溶解性病变。手术活检显示肉芽肿性炎症，伴有巨细胞胞质内包涵体。真菌学检查发现皮炎芽生菌，该菌对酮康唑反应良好。在3.5年的随访中，结果良好。芽生菌病的临床和影像学表现不具有特异性，可能被误诊为肿瘤。诊断延迟很常见。
