Blastomycosis Presenting as a Primary Tracheal Tumor: A Rare Presentation

Abstract

Blastomycosis is a rare fungal infection that typically presents as a pulmonary infection. Systemic involvement of blastomycosis from the lungs commonly occurs in the skin and bones. Tracheal involvement is an unusual presentation of blastomycosis, which makes it a formidable diagnostic challenge. We herein report an unusual case of an 85-year-old man presenting with tracheal blastomycosis presenting as a primary tracheal tumor. We also highlight the challenges that were faced in the diagnosis of such an uncommon presentation. To the best of our knowledge, this is only the third occurrence of blastomycosis with tracheal involvement.

Keywords: bronchoscopy; disseminated blastomycosis; fungal infections; hemoptysis; tracheal tumor.

Figure 1. Bleeding tumor in the mid-tracheal region seen by flexible bronchoscopy.

Figure 2. Positron emission tomography scan showing increased uptake in the mid-tracheal region.

Figure 3. Computed tomography scan showing three pulmonary lesions in the left lower lobe of the lung.

Figure 4. Positron emission tomography of the left lung showing three enhancing lesions.