Pleural Effusion in Pulmonary and Extrapulmonary Blastomycosis

Area of Science:

• Mycology
• Infectious Diseases
• Pulmonology

Background:

• Blastomycosis is a fungal infection primarily affecting the lungs.
• Pleural effusion is an uncommon manifestation of blastomycosis.
• Understanding the incidence and characteristics of blastomycosis-related pleural effusion is crucial for diagnosis.

Purpose of the Study:

• To determine the incidence of pleural effusion in patients with blastomycosis.
• To investigate the involvement of pleural fluid in both pulmonary and extrapulmonary blastomycosis.
• To assess the diagnostic yield of pleural fluid cytology for blastomycosis.

Main Methods:

• Retrospective review of institutional cytology and surgical pathology records from December 1995 to October 2017.
• Analysis of 77 confirmed blastomycosis cases, including pulmonary and extrapulmonary sites.
• Detailed review of clinical, cytologic, and surgical pathology data, with a focus on pleural effusion.

Main Results:

• Pleural effusion was detected in 58.3% of pulmonary blastomycosis cases and 31.0% of extrapulmonary cases.
• Blastomycosis involvement in pleural fluid was confirmed in 50% of aspirated samples from both groups.
• Common extrapulmonary sites included bone, skin, and soft tissue.

Conclusions:

• Pleural effusion is a frequent finding in blastomycosis, irrespective of disease site.
• Blastomycosis should be included in the differential diagnosis for unexplained pleural effusions.
• Prompt diagnosis and antifungal therapy are essential to prevent disease dissemination.