Limits...
Cutaneous blastomycosis: a clue to a systemic disease.

Ortega-Loayza AG, Nguyen T - An Bras Dermatol (2013 Mar-Apr)

Bottom Line: Tissue obtained from the spine confirmed budding yeasts.The patient was diagnosed with disseminated blastomycosis.The patient was treated with amphotericin and itraconazole and completely recovered.

View Article: PubMed Central - PubMed

Affiliation: Virginia Comonwealth University (VCU) – Richmond, VA 23298, USA. aortegaloayza2@mcvh-vcu.edu

ABSTRACT
A 55-year-old male presented with back pain and slightly tender annular plaques with central ulceration on his face. A skin biopsy revealed scattered yeast with broad based buds. A CT scan of the abdomen revealed a pathologic T12 fracture. Tissue obtained from the spine confirmed budding yeasts. The patient was diagnosed with disseminated blastomycosis. The patient was treated with amphotericin and itraconazole and completely recovered.

Show MeSH

Related in: MedlinePlus

H&E and PAS staining of the skin biopsy showing mixed inflammatory infiltrateand fungal organisms. (Courtesy Dr Nooshin K Brinster, MD,Virginia CommonwealthUniversity)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3750900&req=5

f04: H&E and PAS staining of the skin biopsy showing mixed inflammatory infiltrateand fungal organisms. (Courtesy Dr Nooshin K Brinster, MD,Virginia CommonwealthUniversity)

Mentions: A 55 year-old white male from Virginia, USA presented to the emergency room with rightflank and back pain for approximately three weeks and a facial eruption without othersymptoms. On physical examination, the patient was found to have verrucous plaques withraised borders and eroded centers on the left paranasal labial fold and right jawline(Figures 1 and 2). There was no pain to palpation on his abdomen, flank or spine. There were noneurological deficits. HIV test was negative. The patient's CT of the abdomen and pelvisrevealed a pathologic compression fracture at the T12 level (Figure 3). The skin biopsy of the facial lesion showed pseudoepitheliomatoushyperplasia with an inflammatory infiltrate and the presence of broad-based budding fungalorganism suggestive of Blastomyces dermatitidis (Figure4). The fine needle aspiration and bone biopsy as well as the fungal cultureconfirmed the diagnosis. Subsequent chest imaging showed diffuse nodular opacities in alllung lobes. The final diagnosis was disseminated blastomycosis with bone involvement. Thepatient was initially started on itraconazole, but due to symptoms of spinal cordcompression, was ultimately given amphotericin B. The patient completely improved with thistreatment and showed resolution of skin lesions.


Cutaneous blastomycosis: a clue to a systemic disease.

Ortega-Loayza AG, Nguyen T - An Bras Dermatol (2013 Mar-Apr)

H&E and PAS staining of the skin biopsy showing mixed inflammatory infiltrateand fungal organisms. (Courtesy Dr Nooshin K Brinster, MD,Virginia CommonwealthUniversity)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750900&req=5

f04: H&E and PAS staining of the skin biopsy showing mixed inflammatory infiltrateand fungal organisms. (Courtesy Dr Nooshin K Brinster, MD,Virginia CommonwealthUniversity)
Mentions: A 55 year-old white male from Virginia, USA presented to the emergency room with rightflank and back pain for approximately three weeks and a facial eruption without othersymptoms. On physical examination, the patient was found to have verrucous plaques withraised borders and eroded centers on the left paranasal labial fold and right jawline(Figures 1 and 2). There was no pain to palpation on his abdomen, flank or spine. There were noneurological deficits. HIV test was negative. The patient's CT of the abdomen and pelvisrevealed a pathologic compression fracture at the T12 level (Figure 3). The skin biopsy of the facial lesion showed pseudoepitheliomatoushyperplasia with an inflammatory infiltrate and the presence of broad-based budding fungalorganism suggestive of Blastomyces dermatitidis (Figure4). The fine needle aspiration and bone biopsy as well as the fungal cultureconfirmed the diagnosis. Subsequent chest imaging showed diffuse nodular opacities in alllung lobes. The final diagnosis was disseminated blastomycosis with bone involvement. Thepatient was initially started on itraconazole, but due to symptoms of spinal cordcompression, was ultimately given amphotericin B. The patient completely improved with thistreatment and showed resolution of skin lesions.

Bottom Line: Tissue obtained from the spine confirmed budding yeasts.The patient was diagnosed with disseminated blastomycosis.The patient was treated with amphotericin and itraconazole and completely recovered.

View Article: PubMed Central - PubMed

Affiliation: Virginia Comonwealth University (VCU) – Richmond, VA 23298, USA. aortegaloayza2@mcvh-vcu.edu

ABSTRACT
A 55-year-old male presented with back pain and slightly tender annular plaques with central ulceration on his face. A skin biopsy revealed scattered yeast with broad based buds. A CT scan of the abdomen revealed a pathologic T12 fracture. Tissue obtained from the spine confirmed budding yeasts. The patient was diagnosed with disseminated blastomycosis. The patient was treated with amphotericin and itraconazole and completely recovered.

Show MeSH
Related in: MedlinePlus