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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Blastomycosis is an unusual fungal infection in children. It is often a chronic infection characterized by granulomatous and suppurative lesions. Clinical manifestations include either pulmonary findings or disseminated disease. Disseminated blastomycosis usually begins with a lung infection that spreads to the skin, bones, and central nervous system. This is a case report of a child with chronic blastomycosis presenting with chronic paronychia, fever, cough, malaise, and back pain. The child underwent surgical drainage of a paravertebral abscess and administration of intravenous amphotericin B. He was discharged in good condition on oral therapy with ketoconazole. The literature on blastomycosis, with particular emphasis on clinical presentations and management, is reviewed. When the history and physical examination suggest a chronic granulomatous or disseminated disease, such as tuberculosis, the physician must include blastomycosis in the differential.
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PMID:Chronic paronychia, osteomyelitis, and paravertebral abscess in a child with blastomycosis. 1103 69

Blastomycosis is a fungal infection acquired via inhalation of Blastomyces dermatitidis. The majority of cases occur in central, southeastern, and mid-Atlantic areas of the United States. We report the case of a 42-year-old veteran infected with the human immunodeficiency virus who presented in E1 Paso, Texas, with a dry cough, fever, and recent weight loss. We review the clinical and epidemiologic features of blastomycosis. Diagnostic criteria and pharmacologic management are discussed. Active duty personnel are at high risk of exposure to B. dermatitidis. Military providers should maintain an index of suspicion for blastomycosis in endemic and nonendemic regions.
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PMID:Acquired immunodeficiency syndrome-related blastomycosis in an unusual geographic location. 1172 16

An 8-year-old, male castrated golden retriever presented for cough and increased respiratory effort. Radiographs revealed an alveolar pattern in the right caudal lung lobe and an opacity at the carina suspected to be enlarged tracheobronchial lymph nodes. The disease progressed to involve the right middle lung lobe. Cytopathology of a fine-needle aspirate and bronchoalveolar lavage fluid were nondiagnostic. Surgical removal of the right caudal lung lobe and biopsy of the perihilar lymph nodes revealed pulmonary thromboembolism and reactive lymph nodes. The dog died several days postoperatively, and necropsy revealed diffuse pulmonary thromboembolism. Additionally, Blastomyces dermatitis organisms were identified in a pyogranulomatous mass surrounding the trachea near the carina. In an extensive literature search, no reports of pulmonary thromboembolism associated with blastomycosis were identified. It is suspected that the inflammation secondary to blastomycosis caused the thromboembolism.
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PMID:Pulmonary thromboembolism associated with Blastomyces dermatitidis in a dog. 1222 26

We describe a case of blastomycosis in a diabetic patient from South India who had visited Milwaukee, Wisconsin, an endemic area for blastomycosis in the USA. After his return to Bangalore, India, the patient developed intermittent fever of moderate to high grade, cough, loss of weight and appetite, and abscesses in the left cubital fossa and thigh regions. Systemic examination at our hospital revealed that he had dullness to percussion over the chest region and decreased breath sounds. Direct examination of Gram-stained smears of the pus from an abscess showed many broad-based budding yeast cells and culture yielded a dimorphic fungus later identified as Blastomyces dermatitidis. Histologic examination of the curettage tissue slides stained with hematoxylin and eosin, periodic acid Schiff's reagent, and Gomori's methenamine silver stain procedures showed many broad-based budding cells characteristic of B. dermatitidis. The patient was successfully treated, initially with amphotericin B, followed by oral itraconazole for a period of 6 months. Blastomycosis cases in India are reviewed and the likely source of infection in this patient is discussed.
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PMID:Blastomycosis in a South Indian patient after visiting an endemic area in USA. 1696 69

Blastomyces dermatitidis is a dimorphic fungus endemic to north-western Ontario, Manitoba and some parts of the United States. The fungus is also endemic to parts of Africa. Pulmonary and extrapulmonary findings of a 24-year-old African man who presented with weight loss, dry cough and chronic pneumonia not resolving with antibiotic treatment are presented. The unusual occurrence of pulmonary blastomycosis associated with skin lesions and a moderate pleural effusion is reported.
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PMID:Blastomycosis in a young African man presenting with a pleural effusion. 1714 63

An otherwise well 21-year-old man from Northwestern Ontario presented to our emergency department in Winnipeg, Manitoba, with a 2-month history of cough, progressively increasing dyspnea, hemoptysis and a 15-kg weight loss. His symptoms were worsening despite antibiotic treatment for presumed bacterial pneumonia. His past history included work as a seasonal labourer clearing brush. He was not hypoxic on room air, but his chest radiograph revealed a miliary pattern and bilateral infiltrates. A Mantoux test for tuberculosis was non-reactive, and the sputum gram stain was unremarkable. Empiric therapy was initiated for blastomycosis and the diagnosis was confirmed with a calcofluor stain of the sputum. Although blastomycosis is rare in most regions in North America, there is an unusually high incidence of blastomycosis in Northwestern Ontario. This case highlights the intolerance and utility of knowledge of the local epidemiology in establishing difficult diagnoses of regional importance, such as fungal pneumonias.
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PMID:Using local epidemiology to make a difficult diagnosis: a case of blastomycosis. 1735 74

A 4 yr old spayed female Labrador retriever with clinical signs of blindness, cutaneous lesions, coughing, inappetence, and lethargy was diagnosed with disseminated blastomycosis based on cytologic (skin and lymph node aspirates) and histopathologic (skin biopsy) examinations of tissue samples. The dog deteriorated clinically during hospitalization and developed sustained ventricular tachycardia. Echocardiography revealed pericardial effusion, a nodule associated with the left ventricular papillary muscle, and a right atrial mural lesion. Therapy for myocardial performance and glaucoma was initiated. A combination of itraconazole and fluconazole successfully treated the dog. The dog regained vision in the left eye (oculus sinister [OS]) and had no residual cardiac disease detectable by either electrocardiography or echocardiography. This report is unique in documenting survival from intracardiac blastomycosis and in the use of combination azole therapy for treating disseminated disease with intraocular involvement.
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PMID:Successful treatment of intracardiac and intraocular blastomycosis in a dog with combination azole therapy. 2369 Apr 85

The current case report presents a 29-year old man who worked as a hotel guard in a city in China. The patient had fever and dry cough before and after hospitalization. Chest X-ray and CT revealed nodular and patchy lesions in both lower lungs. There were no abnormal findings in the examination of sputum and bronchoalveoular lavage fluid (BALF). He was diagnosed with pulmonary blastomycosis by histological examination of lung biopsy and treated with fluconazole. Follow-up chest CT examination demonstrated that the patient was recovered through appropriate antifungal treatment.
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PMID:Probable pulmonary Blastomyomycocis in an immunocompetent person. 2841 10

Isolated laryngeal blastomycosis is an extremely rare entity with few cases described in the medical literature. Nonspecific and chronic presenting symptoms such as dysphonia, dyspnea, dysphagia, and/or cough are described, with isolated reports requiring urgent management related to respiratory distress. We present a case report of a 63-year-old immunocompetent female diagnosed with isolated laryngeal blastomycosis, document the treatment regimen and subsequent clinical course. In view of the rarity of this diagnosis, isolated laryngeal blastomycosis has the potential for clinical and pathologic misdiagnosis. Without an accurate diagnosis, blastomycosis remains untreated and the risk for airway disease progression increases.
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PMID:Laryngeal Blastomycosis, an Unexpected Diagnosis: A Case Report. 3303 84


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