title: Blastomycosis presenting as multiple splenic abscesses: Case report and review of the literature.
abstract: A 31-year-old Canadian Aboriginal man from northwestern Ontario presented with left upper quadrant pain and a tender left upper quadrant mass. Evaluation with a computed tomography scan showed multiple lesions within the spleen, a collection between the splenic tip and splenic flexure of the colon, and several small adrenal lesions. Computed tomographic-guided needle biopsy showed necrotizing granulomatous inflammation and multinucleated giant cells. Gomori's methenamine silver stain showed broad-based budding yeast consistent with Blastomyces dermatitidis. Abdominal symptoms resolved after two months of oral itraconazole. Multiple splenic abscesses are a rare presentation of blastomycosis and should be considered in the differential diagnosis of left upper quadrant abdominal pain in a patient with a history of travel or residence in a region endemic for B dermatitidis.
authors.affiliation: Department of Surgery, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Sami
authors.initials: S
authors.lastname: Al-Nassar
authors.forename: Tracy
authors.initials: T
authors.lastname: Macnair
authors.forename: Jeremy
authors.initials: J
authors.lastname: Lipschitz
authors.forename: Howard
authors.initials: H
authors.lastname: Greenberg
authors.forename: Elly
authors.initials: E
authors.lastname: Trepman
authors.forename: Sate
authors.initials: S
authors.lastname: Hamza
authors.forename: John M
authors.initials: JM
authors.lastname: Embil