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Endobronchial blastomycoses: A rare pathogen in a unique location.
Elspeth Springsted1, Venkateswara Kollipara2, Badri Giri3
1Department of Internal Medicine, Virginia Tech School of Medicine-Carilion Clinic, Roanoke, VA, USA.
Respiratory Medicine Case Reports
|October 8, 2021
Summary
A rare case of endobronchial blastomycosis, a fungal infection, presented as chronic cough and lung infiltrates in a Southwest Virginia woman. Diagnosis involved CT scans, bronchoscopy, and biopsy confirming Blastomycoses dermatitides.
Area of Science:
- Pulmonology
- Mycology
- Infectious Diseases
Background:
- Blastomycosis is a fungal infection endemic to North America, typically affecting the lungs.
- Endobronchial involvement is an uncommon presentation of pulmonary blastomycosis.
Observation:
- A middle-aged woman presented with a 4-month history of dry cough.
- Computed Tomography (CT) of the chest revealed an infiltrative lung mass.
- Bronchoscopy identified endobronchial lesions in both the right and left main stem bronchi.
Findings:
- Endobronchial biopsy demonstrated acute and chronic granulomatous inflammation.
- Tissue cultures confirmed the presence of Blastomycoses dermatitides.
- The clinical presentation mimicked other pulmonary diseases, delaying diagnosis.
Implications:
- This case highlights the importance of considering fungal infections like blastomycosis in the differential diagnosis of chronic cough and pulmonary infiltrates.
- Early and accurate diagnosis of endobronchial blastomycosis is crucial for effective treatment and improved patient outcomes.
- Increased awareness of geographic endemicity for Blastomycoses dermatitides is essential for clinicians in affected regions.
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