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 results | Negative/normal/no growth results | |
---|---|---|
Blood | -- | Cultures no growth day 5 |
-- | Fungal culture – no fungus isolated | |
-- | AFB culture – no acid-fast bacillus isolated | |
Urine | Blastomyces antigen >200 U/mL | Legionella antigen |
Blastomyces Dermatitidis EIA (enzyme immunoassay) – Detected | Chlamydia + Gonococcal amplified probe | |
Skin (lesion bx) | Fungus smear/culture – light growth | Gram stain – no polymorphonuclear cells. No organisms seen |
Blastomyces dermatitidis | Culture – no growth | |
Fungus Identification – Blastomyces dermatitidis | AFB 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. | |
BAL | Fungal culture – light Blastomyces dermatitidis | AFB culture, AFB smear |
Fungus stain – no yeast or hyphae seen. No | Gram culture, gram stain | |
Fungus identification – Blastomyces | ||
Bronchial washings | Fungal culture – light mold | AFB* culture, AFB smear |
-- | Fungus stain – no yeast or hyphae seen. No | |
Lung biopsy | Fungal culture – rare mold | AFB culture, smear |
-- | Fungus stain – no yeast or hyphae seen. No | |
Feces | -- | Ova and parasite fecal interpretation – negative |
AFP – acid-fast bacilli. |