title: Pulmonary blastomycosis: a case from Africa.
abstract: Pulmonary blastomycosis is an uncommon pathologic condition that is quite rare in Africa compared to endemic regions of Canada and the upper Midwest of the U.S. We describe a 45-year-old patient who complained of productive cough, hemoptysis, and dorsal rachiodynia. Chest imaging revealed a necrotic tissue-density pulmonary mass involving both the upper and lower right lobes. Chest MRI showed signal abnormality of the third thoracic vertebral body and the greater trochanter, consistent with metastatic lesions. Clinical and radiological findings were strongly suggestive of lung cancer. Diagnosis of pulmonary blastomycosis was made by visualization of yeast in bronchial biopsies and further confirmed by culture of bronchoalveolar lavage specimens. The patient was treated with itraconazole and his clinical condition improved markedly. Pulmonary blastomycosis is unusual in Africa and that fact caused a considerable delay in diagnosis. We suggest that this disease may be more common in Africa than has been previously suspected.
authors.affiliation: Pulmonology Department, A.Mami Hospital, Ariana, Tunisia. sana.cheikhrouhou@gmail.com
authors.forename: Sana
authors.initials: S
authors.lastname: Cheikh Rouhou
authors.forename: Hajer
authors.initials: H
authors.lastname: Racil
authors.forename: Olfa
authors.initials: O
authors.lastname: Ismail
authors.forename: Sonia
authors.initials: S
authors.lastname: Trabelsi
authors.forename: Mourad
authors.initials: M
authors.lastname: Zarrouk
authors.forename: Nawel
authors.initials: N
authors.lastname: Chaouch
authors.forename: Sawssen
authors.initials: S
authors.lastname: Hantous
authors.forename: Samira
authors.initials: S
authors.lastname: Khaled
authors.forename: Faouzi
authors.initials: F
authors.lastname: El Mezni
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Chabbou
mesh_terms: D001706:Biopsy; D001759:Blastomycosis / Q000175:diagnosis* / Q000188:drug therapy; D001980:Bronchi / Q000382:microbiology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D014416:Tunisia
chemical_list: D017964:Itraconazole