title: Rapid progression of pulmonary blastomycosis in an untreated patient of chronic lymphocytic leukemia.
abstract: Chronic lymphocytic leukemia (CLL) is associated with a state of immunosuppression characterized by hypogammaglobulinemia as well as B and T lymphocyte dysfunction. Though opportunistic infections are common in CLL patients, particularly after treatment, reports of infections by endemic dimorphic fungi are very few. Here we report a case of pulmonary blastomycosis in a CLL patient who initially presented with an indolent pulmonary mass lesion. The pulmonary lesions progressed rapidly over a two-week period. The diagnosis was established by transbronchial lung biopsy. He was treated with Amphotericin B lipid complex followed by oral itraconazole and recovered uneventfully. This case illustrates the importance of a timely diagnosis and treatment. The presentation of blastomycosis in immunocompromised patients, diagnosis, and treatment are discussed.
authors.affiliation: Divisions of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL 32608, USA ; Pulmonary and Critical Care Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA ; Ben Taub General Hospital, 1504 Taub Loop, BTGH-6PF80002, Houston, TX 77030, USA.
authors.forename: Pralay K
authors.initials: PK
authors.lastname: Sarkar
authors.affiliation: Divisions of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL 32608, USA.
authors.forename: Paras
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Divisions of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL 32608, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Sriram