Abstract

Question: A 66-year-old man, immunocompromised after a recent kidney transplant on graft rejection medications, was admitted for a workup and management of necrotizing pneumonia. Fungal cultures from bronchoalveolar lavage were positive for Blastomyces species and he was diagnosed with disseminated blastomycosis involving the lungs and skin. He had also been experiencing rapidly progressing dysphagia and odynophagia during the 2 weeks before admission. A computed tomography scan of the thorax was consistent with necrotizing left upper lobe pneumonia without any abnormalities to explain his dysphagia.

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