A case of disseminated blastomycosis in New England

IF 1.1 Q4 INFECTIOUS DISEASES
IDCases Pub Date : 2025-01-01 DOI:10.1016/j.idcr.2024.e02139
Cole Royer , Matthew Owens , Kenrick Wysong , Michael Madrid , Katrina Moreau
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Abstract

Blastomyces infections are classified as dimorphic fungal infections commonly seen geographically throughout the Mississippi and Ohio River Valleys, St. Laurence Seaways, as well as the Canadian providences of Ontario Manitoba, and Saskatchewan. Although primarily endemic in the Midwestern United States, there has been a rise in cases throughout New England. Factors that could contribute to this rise of blastomycosis include a changing climate, increasing use of immunosuppressive medications as well as a greater recognition of this disease. Initial presentation of blastomycosis follows the inhalation of fungal spores which can cause flu-like symptoms or mimic acute pneumonia. Blastomycosis can also present as a disseminated infection through extrapulmonary spread in both immunocompromised and immunocompetent hosts and cases present at similar rates within the population. Here we present a case of disseminated blastomycosis in a patient from New England with no reported pre-existing risk factors. The patient developed blastomycosis osteomyelitis in the left elbow which prompted surgical intervention as well as a 12-month regimen of voriconazole therapy. This case outlines the need to adopt better surveillance practices for blastomycosis in non-endemic areas as well as highlights the imperative role of healthcare staff in implementing proper reporting measures to track the spread of blastomycosis.
新英格兰播散性芽孢菌病1例。
芽生菌感染被归类为二形真菌感染,通常在整个密西西比河和俄亥俄河谷,圣劳伦斯海道,以及加拿大安大略省马尼托巴省和萨斯喀彻温省的地理位置上都能看到。虽然主要在美国中西部流行,但在整个新英格兰地区病例有所增加。可能导致芽孢菌病发病率上升的因素包括气候变化、免疫抑制药物的使用增加以及对这种疾病的更多认识。芽生菌病最初表现为吸入真菌孢子,可引起流感样症状或类似急性肺炎。在免疫功能低下和免疫功能正常的宿主中,芽生菌病也可以表现为肺外传播的播散性感染,在人群中发病率相似。在这里,我们提出一个病例播散性芽孢菌病在患者从新英格兰没有报告预先存在的危险因素。患者在左肘出现了芽菌病骨髓炎,这促使手术干预以及12个月的伏立康唑治疗方案。本病例概述了在非流行地区采用更好的芽生菌病监测做法的必要性,并强调了卫生保健人员在实施适当的报告措施以跟踪芽生菌病传播方面的重要作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
IDCases
IDCases INFECTIOUS DISEASES-
CiteScore
2.60
自引率
6.70%
发文量
300
审稿时长
10 weeks
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