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Two Cases Illustrating the Diagnostic Challenge of Pediatric Blastomycosis Presenting as Osteomyelitis.
Gusland, Danièle Y; Livermore, Andrew T; Sterkel, Alana K; Nguyen, Jie C; Conway, James H.
Affiliation
  • Gusland DY; From the University of Wisconsin Hospitals and Clinics.
  • Livermore AT; From the University of Wisconsin Hospitals and Clinics.
  • Sterkel AK; University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Madison, WI.
  • Nguyen JC; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Conway JH; Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI.
Pediatr Emerg Care ; 36(10): e579-e581, 2020 Oct.
Article in En | MEDLINE | ID: mdl-32205801
ABSTRACT
Blastomyces dermatitidis is a dimorphic fungus endemic to the United States and Canada. Although both Histoplasma and Blastomyces are found in similar geographic regions, Blastomyces is many times more likely to cause dissemination in the immunocompetent host, frequently involving the bone. However, given the indolent nature of this fungal infection and more prevalent bacterial etiologies of osteomyelitis, diagnosis and treatment are often significantly delayed. We review 2 pediatric cases that initially presented with isolated orthopedic symptoms without documented fever or pulmonary complaints, although both had signs of pulmonary infection on imaging. These cases demonstrate the importance of a high level of suspicion as well as appropriate diagnostic workup, including surgical pathology with fungal stains, when evaluating osteomyelitis in patients exposed to a Blastomyces-endemic region.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteomyelitis / Blastomycosis Type of study: Diagnostic_studies Limits: Child / Female / Humans Language: En Journal: Pediatr Emerg Care Journal subject: MEDICINA DE EMERGENCIA / PEDIATRIA Year: 2020 Type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteomyelitis / Blastomycosis Type of study: Diagnostic_studies Limits: Child / Female / Humans Language: En Journal: Pediatr Emerg Care Journal subject: MEDICINA DE EMERGENCIA / PEDIATRIA Year: 2020 Type: Article