Table 1.
Epidemiological and Clinicopathological Details of Human Cases of Blastomyces helicus Infection
| Case | Year | Location (Travel History) | Demographics, y | Medical History | Radiology | Histopathology (Sample) | Sample Isolated | Antifungal Treatmenta | Outcome | Reference |
|---|---|---|---|---|---|---|---|---|---|---|
| h1 | 1970 | Edmonton, Alberta (no recent travel) |
60 M | Alcoholism, diabetes | CXR: Chronic lesions left upper lung | Small single budding yeasts (lung, brain) | CSF | None | Fatal | [1, 2] |
| h2 | 1992 | Swift Current, Saskatchewan | 35 M | Chronic leukemia, steroids | NA | NA | Blood, BM, liver, sputum | NA | Fatal | |
| h3 | 1999 | Texas (Mexico) | F | Lupus | NA | Small yeasts (lung) | Blood | Fluconazole, amphotericin Bb | Survival | |
| h4 | 2004 | Okotoks, Alberta | 45 M | NA | NA | NA | BAL, blood | NA | NA | |
| h5 | 2010 | Northern California | 55 M | Liver transplant | Chest CT: Diffuse ground glass opacities, centrilobular nodules, pleural effusions | None | Blood, pleural fluid | Voriconazole, liposomal amphotericin B |
Fatal | [15] |
| h6 | 2010 | Pocatello, Idaho | NA | NA | NA | NA | BAL | NA | NA | |
| h7 | 2013 | Cameron County, Texas (Kansas) |
3 F | None | CXR: normal. MRI brain: enhancement of bibasilar cisterns |
Negative (brain) | CSF | Fluconazole | Survival | |
| h8 | 2014 | Salt Lake City, Utah (Idaho) | 50 M | HIV (CD4 160 cells/µL), Hodgkin lymphomac | CXR: Diffuse nodules |
Multiply-budding yeasts (blood, BAL) | Blood, BAL | Voriconazole, amphotericin B lipid complex | Fatal | |
| h9 | 2016 | East Bay, California (Mexico; Central Valley, California) | 40 M | HIV (CD4 count, 5 cells/µL) | CXR: Diffuse nodules. Chest CT: Diffuse nodules, apical cavitation. | Hyphae and multiply-budding yeasts (lung) | BAL | Fluconazole, micafungin, liposomal amphotericin B |
Fatal | [16] |
| h10 | 2017 | Omaha, Nebraska | NA | NA | NA | NA | BAL, pleural fluid | NA | NA |
Abbreviations: BAL, bronchoalveolar lavage; BM, bone marrow; CSF, cerebrospinal fluid; CXR, chest radiograph; CT, computed tomography; F, female; HIV, human immunodeficiency virus; M, male; MRI, magnetic resonance imaging; NA, data not available.
aAntifungals were prescribed sequentially for all treated patients except for case h8 who received these concurrently.
bAmphotericin B formulation unknown.
cDay 10 after high-dose chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine.