North American blastomycosis in Africans

Area of Science:

• Infectious Diseases
• Mycology
• Neurology

Background:

• Tuberculosis is a common diagnosis for vertebral lesions, particularly in patients from endemic regions.
• Neurological deficits can arise from vertebral pathologies, necessitating a thorough etiological investigation.

Observation:

• Two patients, one from Libya and one Sudanese from Saudi Arabia, presented with neurological deficits secondary to vertebral lesions.
• Neither patient had a history of travel to North America, the endemic region for North American blastomycosis.

Findings:

• Despite initial tuberculosis diagnoses, North American blastomycosis was established as the correct diagnosis for both patients.
• Both patients demonstrated significant clinical improvement and recovery following treatment with amphotericin B.

Implications:

• This case highlights the importance of considering geographically disparate fungal infections like North American blastomycosis in the differential diagnosis of vertebral lesions with neurological deficits.
• It underscores the need for broad diagnostic considerations beyond endemic infectious diseases, especially in international patients.
• Successful treatment with amphotericin B confirms its efficacy in managing disseminated North American blastomycosis presenting with spinal involvement.