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Cutaneous Blastomycosis Mimicking Breast Malignancy
Rose Chisenga1, Tulika Chatterjee1, Zita Erbowor-Becksen1
1Internal Medicine, University of Illinois College of Medicine, Peoria, USA.
Cureus
|September 20, 2021
Summary
This case report details a rare instance of localized breast blastomycosis in a 50-year-old female. Early diagnosis and treatment with antifungals and antibiotics led to significant recovery.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Blastomycosis, a systemic fungal infection caused by *Blastomyces dermatitidis*, typically affects the lungs but can manifest in other organs.
- Localized cutaneous blastomycosis, particularly affecting the breast, is an infrequent clinical presentation.
- Distinguishing blastomycosis from other conditions like malignancy or bacterial infections is crucial for timely and effective treatment.
Observation:
- A 50-year-old female presented with a progressively ulcerating nodule on her left breast, initially suspected to be malignant.
- Diagnostic workup revealed cutaneous blastomycosis complicated by secondary bacterial infections, including *Staphylococcus aureus* and *Klebsiella oxytoca*.
- Computed tomography (CT) of the chest showed no evidence of pulmonary involvement, indicating a localized presentation.
Findings:
- The patient received a seven-day course of Amphotericin B, followed by nine months of oral Itraconazole for blastomycosis.
- Bacterial superinfections were treated with amoxicillin-clavulanate.
- Significant clinical improvement was observed at the six-month follow-up evaluation.
Implications:
- This case highlights the importance of considering blastomycosis in the differential diagnosis of breast lesions, even in the absence of pulmonary symptoms.
- Cutaneous blastomycosis can mimic various dermatological and neoplastic conditions, potentially leading to diagnostic delays.
- Prompt recognition and appropriate management combining antifungal and antibiotic therapies are essential for favorable outcomes in localized blastomycosis.
