Cervical manifestation of blastomycosis.
Blastomycosis is a common systemic fungal infection in which the physical and radiographic findings appear far more serious than the subjective signs and symptoms. Although blastomycosis of the head and neck is often difficult to diagnose, clues in the patient's history and a few laboratory tests can establish the diagnosis. Involvement of the skin and soft tissues provides an unusual opportunity for direct access to the organism for culture and pathologic diagnosis. We present a case of blastomycosis presenting in a single abscessed cervical lymph node. The diagnosis was established by fine-needle aspiration of the cervical mass. The primary lung disease was confirmed by chest radiography and computed tomography. The clinical and pathologic features of the disease are discussed. [Editorial comment: Pulmonary blastomycosis may present with cervical adenopathy. This article demonstrates the potential value of fine needle aspiration in establishing this diagnosis.]
Penn State Hershey Medical Center, Division of Otolaryngology, PO Box 850, Hershey, PA 17033, USA.
J M
JM
Schweinfurth
E
E
Powitzky
D000328:Adult; D001707:Biopsy, Needle; D001759:Blastomycosis / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D009333:Neck / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography
D017964:Itraconazole