Pulmonary sequestration with primary blastomycosis. Failure of ketoconazole therapy after resection.
Infection with Blastomyces dermatitidis developed in a girl with occult pulmonary sequestration. Six months after resection, while receiving ketoconazole, she developed an abscess due to B dermatitidis over the scar from thoracotomy, with a sinus tract to the eighth rib. This was successfully managed with débridement, rib resection, and amphotericin B. Contiguous bone involvement should be suspected in sequestra infected with this organism; débridement and therapy with amphotericin B might be indicated.
Serneels
R A
RA
Department of Pediatrics, University of Louisville School of Medicine, Ky.
Marshall
G S
GS
Wampler
J
J
Miller
D
D
Adams
G
G
D001759:Blastomycosis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D001998:Bronchopulmonary Sequestration / Q000150:complications* / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D012008:Recurrence; D017211:Treatment Failure
D007654:Ketoconazole