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Related Experiment Videos

Cholangitis due to Blastomyces dermatitidis.

M E Ryan1, J P Kirchner, T Sell

  • 1Department of Internal Medicine, Marshfield Clinic, Wisconsin.

Gastroenterology
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

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A rare fungal infection caused by Blastomyces dermatitidis was identified in a 70-year-old woman's biliary tree. Treatment with amphotericin B successfully eradicated the infection, highlighting the need to consider fungal causes in elderly patients with biliary disease.

Area of Science:

  • Medical Mycology
  • Hepatobiliary Medicine
  • Infectious Diseases

Background:

  • Biliary tract diseases are common in the elderly, often presenting with nonspecific symptoms.
  • Cholestatic liver enzyme patterns and dilated intrahepatic ducts warrant thorough investigation.
  • Fungal infections of the biliary system are uncommon but can mimic other pathologies.

Observation:

  • A 70-year-old woman presented with nonspecific complaints and cholestatic liver enzymes.
  • Radiographic imaging revealed a dilated left intrahepatic ductal system.
  • Endoscopic retrograde cholangiopancreatography showed irregular stones and a filling defect in the left hepatic duct.

Findings:

  • Surgical exploration identified a stonelike lesion at the left hepatic duct orifice and a miliary infection pattern in the left liver lobe.

Related Experiment Videos

  • Histologic and microbiologic studies confirmed Blastomyces dermatitidis infection.
  • Treatment with amphotericin B led to complete eradication of the fungal infection.

    • Implications:

    • This case underscores the importance of considering fungal infections, such as Blastomyces dermatitidis, in the differential diagnosis of biliary tract disease.
    • The elderly and immunocompromised individuals are particularly susceptible to such rare infections.
    • Prompt diagnosis and appropriate antifungal therapy are crucial for successful management of biliary fungal infections.