Beware of the Acute Respiratory Distress Syndrome in a Pulmonary Blastomycosis!

Autor: Avinash Vangara MD, Dedeepya Gullapalli MD, Jayaram Krishna Depa MD, Sandhya Kolagatla MD, Muhammad Ali MD, Subramanya Shyam Ganti MD, FCCP
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Investigative Medicine High Impact Case Reports, Vol 12 (2024)
Druh dokumentu: article
ISSN: 2324-7096
23247096
DOI: 10.1177/23247096241233042
Popis: Blastomyces dermatitidis is a dimorphic fungus that can range from mild to severe disease presentation, including the acute respiratory distress syndrome (ARDS) based on the individual’s immunity. Acute respiratory distress syndrome is an uncommon presentation having an incidence of about 10% to 15% but has a high mortality exceeding 90%. This is a case of a 50-year-old female with past medical history of asthma and type 2 diabetes mellitus who presented to the pulmonology clinic with worsening dyspnea for the last 2 months. She also had a lesion in the left lower back, which was draining purulent fluid. Chest radiographs showed bilateral infiltrates and was started empirically on vancomycin and piperacillin-tazobactam. Bronchoalveolar lavage was done and the cultures grew B dermatitidis. The patient was moved to a higher level of care and given amphotericin B. Unfortunately, the patient experienced septic shock, which later deteriorated into cardiac arrest, ultimately leading to their passing. The importance of early diagnosis of blastomycosis and timely treatment has been emphasized in this case report.
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