A disseminated blastomycosis case mimicking metastatic malignancy

Y. YENİÇERİOĞLU, N. YULUĞ, O. TARHAN, C. CEYLAN, E. S. UÇAN, A. KARGI, Ö. SAĞOL, S. ŞAHİN, K. BİBEROĞLU, H. ABACIOĞLU, P. BALCI, E. HAZAN, K. N. TUTUCU, A. H. ÇIMRIN, E. ALICI

Abstract

A DISSEMINATED BLASTOMYCOSIS CASE MIMICKING METASTATIC MALIGNANCY Blastomycosis is a chronic fungal infection characterized by granulamatous and puppurative lesions, the infection usually begins ii lungs and may spread throughout the body. Disseminated infection cam mimic metastatic malignancy. The disease is reported c be quite rare in Turkey. Only one case hâs been reorted in Turkey so far. A 63 year olid woman suffering from back pain, dispnc and weight loss has been hospitalized with preliminary diagnosis of metastatic malignancy on observation of a mass lesion causin; rib distruotion in left hemithorax. In further radiodiagnostic studies, a six cm. mass causing rib destruction and invadin; surrounding tissues and a paravertebral mass with an intramedullary extension causing vertebral destruction were observed ii thoracoabdominal CT. On failure to get an spesific diagnosis by means of microbiologial and cytological examinations of material: obtained percutaneously, thracic lesion excised surgically yielding the diagnosis of blastomycosis by demonsration c microorganism in the pathological sections. Amphotericine B therapy has began leading to clinical improvement. Afterwards sh< has operated for the purpose of vertebral debridment and stabilization, but unfortunately she has died of disseminate! intravascular coagulation in the early post operative period. The case is presented because of its invasive clinical course and bein< the second case reported in Turkey;

Özet

Blastomikoz granülomatöz ve süpüratif lezyonlarla karakterize kronik bir fungal enfeksiyondur. Ülkemizin içinde bulunduğu coğrai kuşakta nadir olarak bildirilmektedir. Şu ana kadar ülkemizde bildirilen bir olgu saptanmıştır. 63 yaşında kadın hasta, bel ağrısı nefes almada güçlük, kilo 1