TABLE 1.
Patient no. | Age (yr)/sex | Presenting symptom(s) | Comorbidity(ies)/immune status | Radiologic findings at presentation | Other microbiology findings | Final diagnosis | Antifungals started? |
---|---|---|---|---|---|---|---|
1 | 46/F | Fever; new DVT/PICC | Sacral OM 3 months prior | N/A | Enterobacter cloacae BSI | E. cloacae BSI | No |
2 | 67/M | Weight loss, dysphagia | Coronary/peripheral artery disease | Hepatosplenomegaly | H. capsulatum yeast CF (1:16) | Sarcoidosis | No |
3 | 73/M | Incidental cavitary lesion | B-cell lymphoma on chemotherapy | Left lung cavitary lesion | N/A | Unclear etiology | Empirical fluconazole |
4 | 27/F | Fever, cough | None | Bilateral lung infiltrates | N/A | Community-acquired pneumonia | No |
5 | 70/F | Respiratory failure | Lung carcinoma on chemotherapy | Bilateral lung infiltrates | Blastomyces UAg positive (2.19 ng/ml) | Disseminated blastomycosis | Itraconazole |
6 | 81/M | Pancytopenia, noncaseating granuloma in BM | Coronary artery disease | Splenomegaly | H. capsulatum yeast CF (1:16); H. capsulatum ID; M band Coccidioides CF (1:2) | Granulomatous disease, secondary to sarcoidosis | No |
7 | 74/F | Persistent pulmonary infiltrates | Hypertension | Bilateral lung infiltrates | Coccidioides IgG ID positive and CF (1:8) | Coccidioidomycosis | Fluconazole |
8 | 74/M | Elevated ESR | RA on methotrexate | Nodular lung infiltrates | Blastomyces recovered from BAL fluid | Pulmonary blastomycosis | Itraconazole |
9 | 37/M | Lymphadenopathy | Unclear | N/A | Coccidioides spherule identified from lymph node biopsy specimen | Coccidioides lymphadenopathy | Fluconazole |
10 | 55/M | Fever, fatigue | Stem cell transplant on prednisone | Bilateral ground-glass infiltrates | Pseudomonas isolated from sputum | Unclear etiology, initiated on ciprofloxacin | No |
11 | 66/F | Incidental CT finding | Remote esophageal cancer | Upper lobe nodules | N/A | Unclear etiology | No |
12 | 11/F | Fever, dry cough | None | Cavitary infiltrate | Blastomyces EIA and UAg positive | Pulmonary blastomycosis | Itraconazole |
Abbreviations: M, male; F, female; RA, rheumatoid arthritis; BM, bone marrow; DVT/PICC, deep vein thrombosis/peripherally inserted central catheter; ID, immunodiffusion; CF, complement fixation; OM, osteomyelitis; BSI, bloodstream infection; WL, weight loss; BAL, bronchoalveolar lavage; ESR, erythrocyte sedimentation rate; HA, headache; CT, computed tomography; N/A, not applicable.