Blastomyces Antigen Detection for Monitoring Progression of Blastomycosis in a Pregnant Adolescent

Megan Tarr,Jennifer L Burns,L Joseph Wheat,Kanokporn Mongkolrattanothai,John Marcinak,Michelle Durkin,Mahmoud Ismail

doi:10.1155/2007/89059

Abstract

Although disseminated blastomycosis is a rare complication in pregnancy, delay in diagnosis and treatment can be fatal. We investigate the use of the Blastomyces urine antigen in diagnosis following disease progression in the intrapartum, postpartum, and neonatal periods. We describe a case of disseminated blastomycosis in a pregnant adolescent and review the pertinent literature regarding treatment and monitoring blastomycosis in pregnancy and the neonatal periods. This is the first reported case in which the Blastomyces urine antigen is utilized as a method of following disease activity during pregnancy confirming absence of clinically evident disease in a neonate. Urine antigen detection for blastomycosis can be useful for following progression of disease in patients with disseminated blastomycosis in both the intrapartum and postpartum periods.

Highlights

Case ReportWe investigate the use of the Blastomyces urine antigen in diagnosis following disease progression in the intrapartum, postpartum, and neonatal periods
Blastomyces dermatitidis is a dimorphic fungus endemic to the Ohio River and Mississippi River valleys and the Great Lakes Region
Other clinical manifestations include cutaneous papular lesions, osteomyelitis, and frank fungemia; these latter manifestations are secondary to disseminated disease

Summary

Case Report

We investigate the use of the Blastomyces urine antigen in diagnosis following disease progression in the intrapartum, postpartum, and neonatal periods. We describe a case of disseminated blastomycosis in a pregnant adolescent and review the pertinent literature regarding treatment and monitoring blastomycosis in pregnancy and the neonatal periods. This is the first reported case in which the Blastomyces urine antigen is utilized as a method of following disease activity during pregnancy confirming absence of clinically evident disease in a neonate. Urine antigen detection for blastomycosis can be useful for following progression of disease in patients with disseminated blastomycosis in both the intrapartum and postpartum periods

INTRODUCTION

Findings

Mother Baby