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Systemic blastomycosis diagnosed by prostate needle biopsy.

Peter M Neal¹, Anne Nikolai

¹Department of Urology, Marshfield Clinic Indianhead Center, 1020 Lakeshore Drive, Rice Lake, WI 54868, USA. neal.peter@marshfieldclinic.org

Clinical Medicine & Research

|July 2, 2008

Summary

A rare fungal infection, Blastomyces dermatitidis, mimicked a urinary tract infection in a 51-year-old man. Prompt diagnosis via prostate biopsy identified the cause, highlighting the importance of considering endemic fungi in differential diagnoses.

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Area of Science:

Mycology
Urology
Infectious Diseases

Background:

Lower urinary tract symptoms (LUTS) are common and often indicative of infection.
Bacterial prostatitis is a frequent cause of LUTS, typically responsive to antibiotics.

Purpose of the Study:

To report a case of Blastomyces dermatitidis prostatitis presenting as LUTS.
To emphasize the diagnostic challenges and clinical awareness required for fungal infections mimicking bacterial prostatitis.

Main Methods:

Clinical presentation and history of a 51-year-old male patient.
Urological examination findings.
Laboratory investigations including urinalysis and prostate biopsy.

Main Results:

Patient presented with irritative lower urinary tract symptoms for one month.
Initial urinalysis suggested infection, but antibiotic treatment was ineffective.
Prostate biopsy revealed Blastomyces dermatitidis, indicating fungal prostatitis.

Conclusions:

Blastomyces dermatitidis can present with symptoms mimicking bacterial prostatitis.
In endemic areas, fungal infections should be considered in the differential diagnosis of refractory urinary tract symptoms.
Prostate biopsy is crucial for diagnosing fungal prostatitis caused by Blastomyces dermatitidis.