Pulmonary blastomycosis presenting as primary lung cancer

作者：Hussaini Syed Mohammed Qasim; Madut Deng; Tong Betty C; Pavlisko Elizabeth N; Schell Wiley A; Perfect John R; Thielman Nathan M^*

来源：BMC Infectious Diseases, 2018, 18(1): 336.

DOI：10.1186/s12879-018-3244-0

• Blastomycosis
• Dimorphic fungus
• Pulmonary mass
• Posaconazole

Background: Blastomycosis is an endemic mycosis in North America that is caused by the dimorphic fungus Blastomyces dermatitidis. The illness is a systemic disease with a wide variety of pulmonary and extra-pulmonary manifestations. The initial presentation of blastomycosis may easily be mistaken for other infectious or non-infectious etiologies.
Case presentation: We present the case of a 52-year-old African-American male and former smoker that presented to his primary care provider with a 2-week history of non-productive cough, night sweats and weight loss. Initially diagnosed with primary lung malignancy, the patient was subsequently found to have pulmonary blastomycosis mimicking lung cancer. The patient underwent a successful course of treatment with posaconazole.
Conclusions: Chronic blastomycosis can present with clinical and radiographic features indistinguishable from thoracic malignancies. There is no clinical syndrome specific for blastomycosis, thus a high degree of suspicion is required for early diagnosis. In this case report, we review recent evidence in radiographic features, diagnostic considerations and treatment of the disease.

• 出版日期2018-7-18