title: Uncontrolled pneumonia in a 49-year-old white man.
abstract: METHODS
  A 49-year-old white man.
  Shortness of breath, fever, and ongoing unintended weight loss.
  The patient had arrived at the emergency department of a hospital in St. Augustine, Florida with coughing and progressive shortness of breath. He reported that he had been experiencing these symptoms for the past 6 weeks. He was examined by his primary physician, who had prescribed him a course of antibiotics and treated him on an outpatient basis. The patient reported no improvement in his symptoms at present, despite the antibiotics. He mentioned that he had traveled to St. Augustine, Florida approximately 10 days previously. Medical personnel in the emergency department subsequently performed a chest x-ray on the patient, as well as computed tomography (CT) scanning of his lymphadenopathy. MEDICAL AND FAMILY HISTORY: Positive for hypertension, diabetes mellitus, and osteoporosis. He reported that he has chewed 2 packs of chewing tobacco per day for the past 30 years, occasionally drinks alcohol, and is a nonsmoker with no known allergies.
  Noncontributory.
  Noncontributory.
  
  
  RESULTS
  The patient exhibited mild respiratory distress; however, he was awake, alert, and oriented, with a temperature of 37.3°C. He also exhibited poor respiratory effort with diffuse expiratory rhonchi. His heart rate and heart rhythm were regular, with no murmurs, gallops, or rubs. His bowel sounds were positive; he exhibited no organomegaly and no cyanosis, clubbing, or edema of his extremities.
authors.affiliation: Biology Department, University of North Florida, Jacksonville, FL fortaghizadeh@gmail.com.
authors.forename: Farnoush
authors.initials: F
authors.lastname: Taghizadeh
authors.affiliation: Biology Department, University of North Florida, Jacksonville, FL Pathology Department, Flagler Hospital, St. Augustine, FL.
authors.forename: Raghuraj S
authors.initials: RS
authors.lastname: Raghuwanshi M
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001758:Blastomyces / Q000472:pathogenicity; D001759:Blastomycosis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D014774:Virulence
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B
keywords: BAD 1 (adhesion protein); blastomycosis; broad base budding yeast; fungal infection; liposomal amphotericin B; metaplastic cells