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Published on: February 9, 2011

Cutaneous and disseminated blastomycosis: a pediatric case series

Katherine E Brick1, Beth A Drolet, Valerie B Lyon

  • 1Mayo Clinic, Rochester, Minnesota, USA.

Pediatric Dermatology
|September 29, 2012
PubMed

Insights

Pediatric blastomycosis, a rare fungal infection, often presents with delayed diagnosis and significant dissemination. Cutaneous lesions in children may indicate systemic involvement, highlighting the need for prompt dermatological evaluation.

Area of Science:

  • Mycology
  • Pediatric Infectious Diseases
  • Dermatology

Background:

  • Blastomycosis is a rare fungal infection primarily affecting the lungs.
  • Pediatric cases are uncommon but can lead to severe morbidity due to diagnostic delays.
  • Dissemination to skin, bones, and CNS is a known complication.

Purpose of the Study:

  • To analyze pediatric blastomycosis cases with a focus on dissemination.
  • To highlight the role of cutaneous lesions in diagnosing systemic pediatric blastomycosis.
  • To emphasize the importance of early recognition and investigation by dermatologists.

Main Methods:

  • Retrospective chart review of pediatric blastomycosis cases.
  • Identification of 17 cases at Children's Hospital of Wisconsin (1999-2009).
  • Detailed reporting of five nonimmunosuppressed cases with cutaneous involvement and systemic dissemination.

Main Results:

  • 53% of pediatric cases showed evidence of dissemination (bone, skin, CNS).
  • Six cases presented with cutaneous lesions; five had additional systemic involvement.
  • Cutaneous dissemination occurred in immunocompetent children, suggesting underlying systemic disease.

Conclusions:

  • Delayed diagnosis is common in pediatric blastomycosis, with frequent dissemination.
  • Cutaneous lesions in children can be a key indicator of systemic blastomycosis.
  • Dermatologists play a crucial role in identifying and investigating potential systemic involvement in pediatric cases presenting with skin lesions.

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