Annals of Thoracic Medicine
CASE REPORT
Year
: 2020  |  Volume : 15  |  Issue : 3  |  Page : 174--178

Pulmonary blastomycosis in rural Upstate New York: A case series and review of literature


Nancy W Bethuel, Nadir Siddiqui, Lee Edmonds 
 Bassett Medical Center, Cooperstown, NY, USA

Correspondence Address:
Dr. Nancy W Bethuel
Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326
USA

In a rural medical center in Upstate New York, we observed an increase in pulmonary blastomycosis cases. Herein, we highlight the increased prevalence of blastomycosis in our region, and our experience with the diagnostic dilemma resulting in delayed diagnosis. This delay may have resulted in an increased mortality. A high index of suspicion may help hasten the diagnosis in an otherwise nonendemic area. A single-center retrospective case series of all patients diagnosed with culture-proven blastomycosis is reported at the Bassett Medical Center from 2007 to 2019. Eight cases of confirmed pulmonary blastomycosis were identified. All patients resided in a rural area along the Susquehanna River Basin. Only one case had a travel history to an endemic state. Males accounted for 100% of cases. There was a 50% mortality rate from acute respiratory distress syndrome. Bronchoalveolar lavage (BAL) reliably made the diagnosis. About 40% of patients had a false-negative blastomycosis serology. There was an average delay of 2.5 months from presentation to correct diagnosis due to a lack of consideration for blastomycosis. BAL resulted in a correct diagnosis, while serology was not reliable to exclude the diagnosis. Physicians should include blastomycosis in the diagnostic differential cases of nonresolving pneumonia in Upstate New York, an area not previously considered as endemic. Bronchoalveolar remains the evaluation method of choice if blastomycosis is suspected.


How to cite this article:
Bethuel NW, Siddiqui N, Edmonds L. Pulmonary blastomycosis in rural Upstate New York: A case series and review of literature.Ann Thorac Med 2020;15:174-178


How to cite this URL:
Bethuel NW, Siddiqui N, Edmonds L. Pulmonary blastomycosis in rural Upstate New York: A case series and review of literature. Ann Thorac Med [serial online] 2020 [cited 2021 Oct 26 ];15:174-178
Available from: https://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2020;volume=15;issue=3;spage=174;epage=178;aulast=Bethuel;type=0