[Blastomycosis: report of an imported case in Mexico, with only cutaneous lesions].
BACKGROUND
Blastomycosis is a granulomatous infectious disease. It is caused by the dimorphus fungus Blastomyces dermatitidis. It predominates in the United States of America, but in Mexico two systemic imported cases have been reported. Cutaneous primary blastomycosis is a rare clinical presentation, which occurs after traumatic inoculation of the fungus.


OBJECTIVE
We present a case of a 54 year old male, born in Guadalajara, Mexico, and living in Chicago, USA, who had two verrucous nodules (8mm in diameter) on the forehead and right nasogenian fold, of 4 weeks progression.


METHODS
We made a histopathological study (hematoxylin and eosin, Gomori Groccot and periodic acid-Schiff stains) and mycology studies (direct microscopic examination, Sabouraud and mycobiotic agar cultures). Multiple studies were made with no evidence of systemic spread.


RESULTS
Biopsy showed a dermal inflammatory infiltrate made up of lymphocytes, neutrophils, histiocytes and multinucleated giant cells. A few large, haloed, broad-based budding yeasts were also observed. Direct examination with KOH revealed broad-based budding yeasts, 10μm in diameter. Culture at 35°C yielded a white, pleated colony, which changed into a yellowish cerebriform. Multiple studies were made with no evidence of systemic spread. Itraconazole 200mg qd PO was given over a 2 month period, with a complete clinical and mycological response.


CONCLUSIONS
This is the first imported case in Mexico of blastomycosis with cutaneous lesions without systemic involvement.
Rodríguez-Mena
Adriana
A
Centro de Referencia en Micología Médica (CEREMI), Instituto Dermatológico de Jalisco Dr. José Barba Rubio, Zapopan, Jalisco, México.
Mayorga
Jorge
J
Solís-Ledesma
Guillermo
G
Barba-Gómez
José
J
D001759:Blastomycosis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D014195:Travel; D014481:United States