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22 April 2023: Articles

Classical Presentation of Disseminated Blastomycosis in a 44-Year-Old Healthy Man 3 Months After Diagnosis of COVID-19

Challenging differential diagnosis, Rare disease

Diana Fan A , Ali Ahmad A , Jared Frisby D , Kavita Darji B , Ashley Ojeaga B , Ramona Behshad B , M. Yadira Hurley B , Mallory Abate B , Paul Kunnath A*

DOI: 10.12659/AJCR.938659

Am J Case Rep 2023; 24:e938659

Table 2. A full account of the microbiology results from a 44-year-old man with a diagnosis of blastomycosis. Results are reported as either positive/abnormal/growth results or negative/normal/no growth results. Identification of microorganisms in growth results is reported when applicable.

Positive/abnormal/growth resultsNegative/normal/no growth results
Blood--Cultures no growth day 5
--Fungal culture – no fungus isolated
--AFB culture – no acid-fast bacillus isolated
UrineBlastomyces antigen >200 U/mLLegionella antigen
Blastomyces Dermatitidis EIA (enzyme immunoassay) – DetectedChlamydia + Gonococcal amplified probe
Skin (lesion bx)Fungus smear/culture – light growthGram stain – no polymorphonuclear cells. No organisms seen
Blastomyces dermatitidisCulture – no growth
Fungus Identification – Blastomyces dermatitidisAFB smear – no acid-fast bacilli seen
--AFB* culture – no acid-fast bacillus isolated
Sputum--Culture – moderate normal oropharyngeal flora
--Gram stain:
--AFB culture – no acid-fast bacillus isolated
--AFB smear – no acid-fast bacilli seen
--Fungal culture – no fungus isolated
--Fungus stain – no yeast or hyphae seen. No
Cyst fluid--Culture – no growth
--Gram stain – moderate polymorphonuclear cells. No organisms seen.
BALFungal culture – light Blastomyces dermatitidisAFB culture, AFB smear
Fungus stain – no yeast or hyphae seen. NoGram culture, gram stain
Fungus identification – Blastomyces
Bronchial washingsFungal culture – light moldAFB* culture, AFB smear
--Fungus stain – no yeast or hyphae seen. No
Lung biopsyFungal culture – rare moldAFB culture, smear
--Fungus stain – no yeast or hyphae seen. No
Feces--Ova and parasite fecal interpretation – negative
AFP – acid-fast bacilli.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923