Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Jun 8;12(6):e8508.
doi: 10.7759/cureus.8508.

A Case Report of Disseminated Blastomycosis With Thyroid Involvement in a Pregnant Patient

Amit L Jain  1 , Rahul Peravali  2 , Hemnishil K Marella  1 , Reshma Premkumar  1 , Ankur Seth  1
Affiliations
Case Reports

A Case Report of Disseminated Blastomycosis With Thyroid Involvement in a Pregnant Patient

Amit L Jain et al. Cureus. .

Abstract

Blastomyces dermatitidis is the causal agent of blastomycosis, an invasive and often serious fungal infection. Blastomycosis typically presents as a pulmonary infection, but common extrapulmonary manifestations of blastomycosis include the skin, bones, and reticuloendothelial systems. Disseminated blastomycosis occurs more prominently in immunocompromised individuals, such as organ transplant recipients, HIV patients, and pregnant women. We report here a rare case of disseminated blastomycosis to the thyroid in a pregnant patient. This case emphasizes the unique challenges of diagnosing and treating disseminated fungal infections in pregnancy.

Keywords: blastomyces dermatitidis; blastomycosis; disseminated blastomycosis; thyroid.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial CT chest with contrast
(A) A 3.2 cm x 2.4 cm mass-like density within the left thyroid lobe. (B) Multiple mediastinal lymph nodes with the largest being subcarinal measuring approximately 1.7 cm x 3.6 cm. (C) Left lower lobe consolidation and a small pleural effusion (gray arrow). Additionally, throughout bilateral lungs, there are many subcentimeter solid noncalcified nodules (black arrow).
Figure 2
Figure 2. Thyroid ultrasound
Images A and B showing an ill-defined 2.7 x 2 x 4.3 cm heterogeneous mass occupying most of the left lobe.
Figure 3
Figure 3. Left thyroid fine-needle aspiration biopsy
(A) Blastomyces dermatitidis organism yeast cell with thick double refractive walls. (B) Gomori methenamine silver stain performed on a cytospin slide highlights fungal organism broad-based budding cells morphologically consistent with B. dermatitidis.
Figure 4
Figure 4. Follow-up CT chest without contrast
Follow-up CT chest without contrast after two weeks showing improving pneumonia (black arrow). Also, many solid noncalcified nodules decreased in size (gray arrow).
See this image and copyright information in PMC

References

    1. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. Chapman SW, Dismukes WE, Proia LA, et al. Clin Infect Dis. 2008;46:1801–1812. - PubMed
    1. Clinical and laboratory update on blastomycosis. Saccente M, Woods GL. Clin Microbiol Rev. 2010;23:367–381. - PMC - PubMed
    1. Blastomycosis. Smith JA, Kauffman CA. Proc Am Thorac Soc. 2010;7:173–180. - PubMed
    1. Acute blastomycosis thyroiditis. Moinuddin S, Barazi H, Moinuddin M. Thyroid. 2008;18:659–661. - PubMed
    1. Fine-needle aspiration diagnosis of thyroid blastomycosis. Wineland A, Siegel E, Francis C, Chen C, Bodenner D, Stack BC. Endocr Pract. 2008;14:224–228. - PubMed

Publication types

LinkOut - more resources