Disseminated Blastomycosis during Pregnancy at 11 Weeks Gestation

Caroline E Dillon,Paula A Mckenzie

doi:10.4236/ojog.2022.122012

Abstract

Blastomyces dermatitidis is a dimorphic fungus that typically causes disease in immunocompromised hosts, but can affect immunocompetent patients as well. Here we present a case of disseminated blastomycosis in a pregnant patient at 11 weeks gestation who was successfully treated with systemic antifungal therapy. Data regarding treatment of blastomycosis in pregnancy is limited, and choice of antifungal agent remains challenging due to uncertainties regarding fetal toxicity.

Highlights

Open AccessBlastomycosis is typically caused by direct cutaneous contact or inhalation of the dimorphic fungi Blastomyces dermatitidis
Blastomyces dermatitidis is a dimorphic fungus that typically causes disease in immunocompromised hosts, but can affect immunocompetent patients as well
Though disease can be caused in immunocompetent hosts, case series have found those with an impaired immune system are more likely to have disseminated severe disease [3] [4]

Summary

Open Access

Blastomycosis is typically caused by direct cutaneous contact or inhalation of the dimorphic fungi Blastomyces dermatitidis. Incidence of these infections is typically most common in midwestern, south central, and southeastern regions of the United States, as well as areas of Canada that border the St. Lawrence River Valley and the Great Lakes [1] [2]. B. dermatitidis can cause infection in both immunocompetent and immunocompromised patients. Though disease can be caused in immunocompetent hosts, case series have found those with an impaired immune system are more likely to have disseminated severe disease [3] [4]. We present a case of disseminated blastomycosis in a patient at 11 weeks gestation. A CT-PE study was done and was negative for acute pulmonary embolus but found a mass like consolidation in the anterior left upper lobe with focal area of necrosis concerning for necrotizing pneumonia (Figure 1)

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