title: Secondary intracerebral blastomycosis with giant yeast forms.
abstract: Secondary central nervous system (CNS) blastomycosis is an unusual manifestation of blastomycosis. We report a case of recurrent intracerebral blastomycosis that presented histopathologically with giant yeast-like cells and multinucleation that mimicked Coccidioides immitis. The yeast forms of Blastomyces dermatitidis usually range in size from 8 to 20 microm in diameter. Large or giant yeast forms (20-40 microm) are rare. The four cases previously reported in the literature involving giant yeast cell forms of B. dermatitidis are reviewed here. Intracerebral blastomycosis should be suspected in patients with signs and symptoms of CNS lesions and histories of primary blastomycosis, or treatment with corticosteroids, or comprised immune systems. The diagnosis should be confirmed by culture which presents typical biphasic microbiologic features.
authors.affiliation: Department of Pathology, Clinical Microbiology Laboratory, University of Illinois, Chicago, Illinois 60612, USA.
authors.forename: Shou Jin
authors.initials: SJ
authors.lastname: Wu
authors.forename: Tibor
authors.initials: T
authors.lastname: Valyi-Nagy
authors.forename: Herbert H
authors.initials: HH
authors.lastname: Engelhard
authors.forename: Mary Anhthu
authors.initials: MA
authors.lastname: Do
authors.forename: William M
authors.initials: WM
authors.lastname: Janda
mesh_terms: D000293:Adolescent; D000368:Aged; D001758:Blastomyces / Q000166:cytology* / Q000302:isolation & purification*; D001759:Blastomycosis / Q000175:diagnosis / Q000382:microbiology; D001921:Brain / Q000000981:diagnostic imaging* / Q000382:microbiology; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography