Novel cases of blastomycosis acquired in Toronto, Ontario

Lester, Robert S.; DeKoven, Joel G.; Kane, Julius; Simor, Andrew E.; Krajden, Sigmund; Summerbell, Richard C.
November 2000
CMAJ: Canadian Medical Association Journal;11/14/2000, Vol. 163 Issue 10, p1309
Academic Journal
AbstractBlastomycosis, a potentially fatal fungal disease, is well known from defined areas of endemicity in Ontario, primarily in the northern part of the province. We present 2 unusual cases that appear to extend the area of endemicity into urban southern Ontario, specifically Toronto. Both patients presented to a dermatology clinic with skin lesions. Chest radiography, history and general physical evaluation indicated no disease at other body sites. Both cases appeared to represent "inoculation blastomycosis" connected with minor gardening injuries and a cat scratch respectively. Atypical dissemination could not be completely excluded in either case. Neither patient had travelled recently to a known area of high endemicity for blastomycosis, nor had the cat that was involved in one of the cases. Physicians must become aware that blastomycosis may mimic other diseases, including dermal infections, and may occur in patients whose travel histories would not normally suggest this infection.Case 1The patient was a 59-year-old immunocompetent woman with no history of recent travel to known areas of endemicity for blastomycosis. She had, however, been gardening in a ravine area of western Toronto near a stream.In March 1998 a lesion developed over the patient's right lateral malleolus, gradually increasing in size. She described the initial lesion as being similar to a pimple. Approximately 2 months later, similar lesions developed on 2 fingers. Several biopsies revealed no distinctive features. A variety of antimicrobial agents were administered without effect. She was referred to a dermatology centre.Dermatological examination indicated a large, erythematous, scaling plaque on the right lateral malleolus and verrucous, indurated lesions on the left index and right ring fingers. The areas surrounding the plaques were slightly violaceous, and pressure led to purulent discharge. Samples were obtained for repeat biopsy. Histopathologic findings were interpreted as...


Related Articles

  • Cutaneous blastomycosis in New Brunswick: case report. Ross, John J.; Keeling, Douglas N. // CMAJ: Canadian Medical Association Journal;11/14/2000, Vol. 163 Issue 10, p1303 

    AbstractBlastomycosis is a fungal infection of immunocompetent hosts. We present a case of cutaneous blastomycosis acquired in New Brunswick, which provides evidence that this disease is endemic in Atlantic Canada. This case also demonstrates that the diagnosis of blastomycosis may be elusive....

  • Blastomycosis-Like Pyoderma-A Rare Case Report. HONGAL, AMRITA A.; GEJJE, SOMASHEKAR // Journal of Clinical & Diagnostic Research;Oct2016, Vol. 10 Issue 10, p3 

    Blastomycosis-like pyoderma is a rare, cutaneous bacterial infection of skin, seen in malnourished individuals, in a poor state of health and manifests as vegetating skin lesions. It is an unusual tissue reaction possibly to bacterial infection, the most common organism being Staphylococcus...

  • A short chemical sensitivity scale for assessment of airway sensory hyperreactivity. Nordin, Steven; Millqvist, Eva; Löwhagen, Olle; Bende, Mats // International Archives of Occupational & Environmental Health;May2004, Vol. 77 Issue 4, p249 

    Objectives. A short version of the 21-item Chemical Sensitivity Scale (CSS), called the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), was developed and evaluated for the quantifying of self-reported affective reactions to and behavioral disruptions in daily activities by...

  • The Impact of A Multidisciplinary, Holistic Approach to Management of Patients Diagnosed with Multiple Chemical Sensitivity on Health Care Utilization Costs: An Observational Study. Fox, Roy A.; Joffres, Michel R.; Sampalli, Tara; Casey, Jill // Journal of Alternative & Complementary Medicine;Mar2007, Vol. 13 Issue 2, p223 

    Objective: The aim of this study was to look at the impact of a multidisciplinary approach to treatment of individuals with multiple chemical sensitivity (MCS) and to present preliminary results which compare health care utilization pre- and postmanagement of individuals with MCS. Study design:...

  • Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: study protocol for a randomized, double-blind, placebo-controlled trial. Dao Tran, Marie Thi; Skovbjerg, Sine; Arendt-Nielsen, Lars; Christensen, Karl Bang; Elberling, Jesper; Tran, Marie Thi Dao // Trials;2013, Vol. 14 Issue 1, p1 

    Background: Multiple chemical sensitivity (MCS) is a chronic condition of unknown etiology. MCS is characterized by recurrent nonspecific symptoms from multiple organ systems in response to chemical exposures in concentrations that are normally tolerated by the majority of the...

  • CHROMOBLASTOMYCOSIS: A RARE CASE OF INFECTION BY Fonsecaea compacta FROM WESTERN MAHARASHTRA, INDIA. ANGADI, K. M.; MISRA, R. N.; GANDHAM, N. R.; MOUMITA, S.; VYAWAHARE, C. R.; SINGHANI, S. S.; JADHAV, S. V. // International Journal of Microbiology Research;2012, Vol. 4 Issue 9, p330 

    Chromoblastomycosis is a fungal infection of the cutaneous and subcutaneous tissues. It is non contagious and chronic fungal infection. Several species of pheoid or dematacious fungi which are saprophytes are the causative agents. Infection occurs when the causative agent enters the body with...

  • Blastomycosis-like pyoderma. Sawalka, Shweta S.; Phiske, Meghana M.; Jerajani, H. R. // Indian Journal of Dermatology, Venereology & Leprology;Mar/Apr2007, Vol. 73 Issue 2, p117 

    A 9-year-old female, presented with recurrent bilaterally symmetrically distributed flesh colored vegetative plaques, papules and nodules on trunk, and upper and lower extremities since 15 days. Investigations revealed anemia, hypoproteinemia, decreased albumin and positive D-xylose test. Pus...

  • A tale of two audits: closing the feedback loop on clearance rates of anogenital warts at three months. Davison, W.; Challenor, R. // International Journal of STD & AIDS;Feb2012, Vol. 23 Issue 2, p133 

    Our management of anogenital warts was audited. By case-note review 95% were clear of original warts by three months (assuming wart clearance if patients stopped attending). However, by confirmed outcome (documented in case-notes or verified by telephone) only 81% were clear. The main reason for...

  • Polymerase chain reaction for diagnosis of genital herpes in a genitourinary medicine clinic. A. Scoular // Sexually Transmitted Infections;Feb2002, Vol. 78 Issue 1, p21 

    Background: Polymerase chain reaction (PCR) has well established advantages over culture for diagnosis of herpes viruses, but its technical complexity has limited its widespread application. However, recent methodological advances have rendered PCR more applicable to routine practice. Aim: To...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics