Blastomycosis of the head and neck.
BACKGROUND
Blastomyces dermatitidis infection of head and neck structures is a rare clinical entity. However, the potential for significant morbidity warrants clinical consideration and timely diagnosis.


OBJECTIVE
To describe the clinical presentations, diagnostic challenges, and outcomes of otolaryngologic blastomycosis.


METHODS
A literature search of the Pubmed and Ovid databases with the terms "blastomycosis AND. . . " followed by all terms related to anatomical regions of the head and neck.


METHODS
All publications which discussed pertinent otolaryngologic involvement from blastomycotic infections were evaluated.


CONCLUSIONS
The larynx was the most commonly reported site of infection, followed by the oral cavity, neck, ear, nasal cavity/paranasal sinuses, and skull base/orbit/calvarium. Diagnosis of blastomycosis was almost universally delayed due to the resemblance of presentation to more common clinical entities, most notably squamous cell carcinoma. A substantial portion of cases (42%) presented without clinical or radiographic evidence of pulmonary infection. The initial diagnostic confusion often resulted in disease progression and trials of invasive therapies. Most patients experienced complete resolution of symptoms and lesions within months of initiation of proper antifungal medications. Permanent sequelae were relatively uncommon and related to the structures involved in the primary infection.
Stritch School of Medicine, Loyola University Health Systems, Maywood, IL.
J
J
Rucci
Stritch School of Medicine, Loyola University Health Systems, Maywood, IL.
G
G
Eisinger
Stritch School of Medicine, Loyola University Health Systems, Maywood, IL.
G
G
Miranda-Gomez
Department of Pediatrics, Ronald McDonald Children's Hospital, Loyola University Health Systems, Maywood, IL. Electronic address: jinguyen@lumc.edu.
J
J
Nguyen
D000935:Antifungal Agents / Q000627:therapeutic use; D001759:Blastomycosis / Q000175:diagnosis / Q000188:drug therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000188:drug therapy
D000935:Antifungal Agents