1/7. Chronic paronychia, osteomyelitis, and paravertebral abscess in a child with blastomycosis.blastomycosis is an unusual fungal infection in children. It is often a chronic infection characterized by granulomatous and suppurative lesions. Clinical manifestations include either pulmonary findings or disseminated disease. Disseminated blastomycosis usually begins with a lung infection that spreads to the skin, bones, and central nervous system. This is a case report of a child with chronic blastomycosis presenting with chronic paronychia, fever, cough, malaise, and back pain. The child underwent surgical drainage of a paravertebral abscess and administration of intravenous amphotericin b. He was discharged in good condition on oral therapy with ketoconazole. The literature on blastomycosis, with particular emphasis on clinical presentations and management, is reviewed. When the history and physical examination suggest a chronic granulomatous or disseminated disease, such as tuberculosis, the physician must include blastomycosis in the differential.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. public health response to 2 clinical cases of blastomycosis in colorado residents.We summarize the public health response after the identification of 2 cases of pneumonia caused by blastomyces dermatitidis infection in colorado residents. The response to these cases emphasizes the need for physicians to add fungal infection to the list of differential diagnoses for patients who have refractory pneumonia, even those who live in areas of nonendemicity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. urine antigen detection of blastomycosis in pediatric patients.blastomycosis is an uncommonly recognized disease in pediatric patients. We describe 4 cases of pediatric blastomycosis that presented to our children's hospital, 2 with isolated pulmonary blastomycosis and 2 with disseminated blastomycosis. Because of variable clinical presentations and morbidity if treatment is delayed, physicians must maintain a high index of suspicion and obtain appropriate diagnostic tests promptly. For the first time, we report the effect of therapy on blastomyces antigen clearance. In our experience, the urine antigen detection for B. dermatitidis is useful for diagnosis and follow up during therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Canine blastomycosis as a harbinger of human disease.blastomycosis occurred in six patients in five households. In each instance one or more dogs living with the family or living near the family also developed blastomycosis. The recognition of canine blastomycosis helped in the early diagnosis of human cases. Because both dogs and patients were probably infected at the same place, canine blastomycosis may be an important epidemiologic marker, alerting physicians to the possible presence of concomitant blastomycosis in humans.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. blastomycosis: diagnostic difficulties.In five cases of blastomycosis, invasive procedures were required before the diagnosis was established; these included thoracotomy in two cases and craniotomy in a third case. Radiologic signs in blastomycosis are nonspecific, and the presentations of the disease may be protean and unusual. Certain factors and radiologic appearances should alert the physician and radiologist to the diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. A case report of disseminated blastomycosis and adult respiratory distress syndrome.blastomycosis is a fungal disease endemic to the midwestern and southeastern united states. This is a case report of a 29-year-old woman who presented with weight loss, fever, fatigue, and pneumonia. She developed disseminated blastomycosis, adult respiratory distress syndrome (ARDS), and ulcerative skin lesions, requiring mechanical ventilation, amphotericin b, and multiple surgeries. blastomycosis is endemic to a large portion of the United States. family physicians should consider fungal infection in the differential diagnosis of an unresolving pneumonia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. blastomycosis-induced respiratory failure: the successful application of continuous positive airway pressure.A patient diagnosed with pulmonary blastomycosis was seen initially by her primary care physician for severe pain in her right elbow and was treated with steroid therapy and analgesics. She also had been treated for chronic cough and congestion for approximately 2 months before admission. She showed no improvement at home. She was hospitalized for right epicondylitis, and progressively worsening restrictive pulmonary symptoms developed, including hypoxemia and dyspnea. She was transferred to the intensive care unit and treated with mask continuous positive airway pressure (CPAP) and intravenous amphotericin b. Despite worsening hypoxemia, successful management of oxygenation was achieved with CPAP, averting the need for intubation and mechanical ventilation. This case demonstrates the usefulness of CPAP in infectious disorders that create restrictive lung impairment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |