Machecha Natallia, Phagoora Jaskomal, Sahni Sonu, Meza Luis F
Pulmonary, Critical Care, and Sleep Medicine, East Carolina University Brody School of Medicine, Greenville, USA.
Medicine, Touro College of Osteopathic Medicine, New York City, USA.
Cureus. 2024 Sep 12;16(9):e69276. doi: 10.7759/cureus.69276. eCollection 2024 Sep.
is a fungus typically found in the soil of endemic regions such as the Midwest, concentrating in areas like Ohio, Mississippi, and the Great Lakes area. The systemic infection caused by inhaling is known as blastomycosis. The frequency of blastomycosis in non-endemic regions is increasing for a variety of speculated reasons, such as higher rates of immunosuppressed individuals and possible climate. Due to clinician unfamiliarity, misdiagnosis of blastomycosis is common, which potentiates worsening systemic infections. This study shows the clinical course of a patient with blastomycosis in a non-endemic region, highlighting the need for education for clinicians in non-endemic areas. A 72-year-old female with a history of chronic obstructive pulmonary disease (COPD), coronary artery disease, a 47-year smoking history, and hypertension presented for outpatient management of COPD. CT three months prior to presentation showed nodular opacities in the lungs. A bronchoscopy was performed and revealed negative findings for malignancy or infection; the patient developed worsening symptoms leading to hospitalization. Subsequent testing revealed . She was promptly treated with a six to 12-month course of itraconazole with close follow-up. The study highlights the need not to rule out causes of infection based on location. Blastomycosis can resemble community-acquired pneumonia. Making the correct diagnosis is paramount, as delays can result in morbidity. Fungal cultures may be the gold standard, but due to the long culture time, there need to be other diagnostic tests like urine antigen testing. This study highlights the need to increase awareness of clinicians who experience blastomycosis patients in a non-endemic region.
是一种真菌，通常存在于中西部等流行地区的土壤中，集中在俄亥俄州、密西西比州和五大湖地区等。吸入该真菌引起的全身感染称为芽生菌病。由于各种推测的原因，如免疫抑制个体比例增加和可能的气候变化，非流行地区芽生菌病的发病率正在上升。由于临床医生不熟悉，芽生菌病的误诊很常见，这会加剧全身感染的恶化。本研究展示了一名非流行地区芽生菌病患者的临床病程，强调了对非流行地区临床医生进行教育的必要性。一名72岁女性，有慢性阻塞性肺疾病（COPD）、冠状动脉疾病病史，有47年吸烟史，还有高血压，前来门诊治疗COPD。就诊前三个月的CT显示肺部有结节状混浊。进行了支气管镜检查，结果显示无恶性肿瘤或感染；患者症状恶化导致住院。后续检测发现……她立即接受了为期6至12个月的伊曲康唑治疗，并密切随访。该研究强调了不要根据地点排除感染原因。芽生菌病可能类似于社区获得性肺炎。做出正确诊断至关重要，因为延误可能导致发病。真菌培养可能是金标准，但由于培养时间长，需要有其他诊断测试，如尿液抗原检测。本研究强调了提高在非流行地区遇到芽生菌病患者的临床医生的认识的必要性。
