Table 1.
Demographic and Clinical Details
| Species | Country | Case ID, Author, year (case no.)a | Year, depositor (where known), Collection or isolate number (NCBI Accession) | Patient age, sex, comorbidities | Sites affected | Description of fungi in tissue | Treatment, Outcome |
|---|---|---|---|---|---|---|---|
| Blastomyces percursus | Angola | 3, Bleeker and Haanen, 1979 [49] | 1974, ATCC 56220,b CBS 514.74,c CDC B3464d | 36, M, Lymphoma (in remission) | Skin, lung | Double-contoured yeast cells, single broad-based buds | Miconazole (3 g daily for 14 weeks), Survived |
| Democratic Republic of Congo (then Zaire) | 7, Bregant et al, 1973 (case 2) [50]; Huerre et al, 2002 (case 3) [32] | 1972, Vandepitte Raymond Vanbreuseghem collection (RV) 28217, IHEM 26955, ATCC 48089 (SAMN13949613; AF071949) | 33, M, None | Rib, skin | Spherical or oval yeasts (9–12 µm), with single buds at broad bases | Amphotericin B (2 g), Survived | |
| Israel | 25, Kemna et al, 1994 [33]; Dukik et al, 2017 [11]; Jiang et al, 2018 [12] | 1993, Polachek UAMH 7425, Centraalbureau voor Schimmelcultures (CBS) 139878, UAMH 7426 (NR 153647; KY195964; KY195971; KY195949; AF038323; AF038324) | 53, M, None | Oral mucosa, palate, skin | Spherical cells, 8–10 µm budding at broad-bases | Fluconazole 400 mg daily for 6 months, Survived | |
| Morocco | 34, Sekkat et al, 1981 [51]; Huerre et al, 2002 (African case 5) [32] | 1978, Collection de L’Institut Pasteur (CIP) 1898.89 (MK521438) | 30, M, None | Skin | Spores resembling B. dermatitidis, measuring 10 µm on average with broad-based budding. 2.5% of fungal cells resembled hyphae | Ketoconazole for 82 days, Survived | |
| Mozambique | 45, Campos Magalhaes et al, 1968 [52]; Huerre et al, 2002 (African case 2) [32] | CDC B838, ATCC 56214 (MK521440) | 18, M None | Bone, skin, soft tissue (foot), lung, prostate | Round yeasts, 8–10 µm, with thick walls and broad-based budding. No hyphal forms | Amphotericin B (2.79 g), prednisone, Survived | |
| South Africa | 65, Heys et al, 2014 (case 1) [53]; Schwartz et al, 2015 (case 34) [54]; Dukik et al, 2017 [10]; Maphanga et al, 2020 (case 2) [14] | 2008, Govender BP222 (LGTZ00000000) | 58, M, None (HIV−) | Brain, lungs | Broad-based budding yeasts with double contoured refractile walls, some forming pseudohyphae | Amphotericin B for 14 days, followed by itraconazole, Survived | |
| 66, Schwartz et al, 2015 (case 45) [54]; Maphanga et al, 2020 (case 3) [14] | 2014, SA-NICD-06 (QGQT00000000) | 52, M, None | Lung, endobronchial mass, skin | Broad-based budding yeast with double refractile walls suggestive of B. dermatitidis | Amphotericin B, followed by itraconazole, Survived | ||
| 67, Maphanga et al, 2020 (case 4) [14] | 2014, SA-NICD-08 (QGQR00000000) | 34, M, None (HIV−) | Skin | Large intracellular fungal cells with thick walls resembling B. dermatitidis | Itraconazole, Survived | ||
| 62, Simon et al, 1977 [55]; Maphanga et al, 2020 (case 5) [14] | 1975, SA-NICD-05 CDC. B3013 (QGQS00000000) | 63, M, None | Tongue, lung | Broad-based budding yeasts resembling B. dermatitidis | None, Died | ||
| 64, Frean et al, 1989 [56]; Carman et al, 1989 [5]; Maphanga et al, 2020 (case 6) [14] | 1983, SA-NICD-04 (QGQQ00000000) | 65, M, None | Skin, lung, kidney, liver, spleen, thyroid | Yeast-like cells resembling B. dermatitidis | Unknown, Died | ||
| 61, Martin and Berson, 1973 (case 2) [57]; Maphanga et al, 2020 (case 7) [14] | 1967, SA-NICD-18 (MH571861, MH644816) | 27, M | Bone (skull, iliac, clavicle, vertebrae), skin | Hour-glass shaped yeasts resembling B. dermatitidis | Amphotericin B, griseofulvin, Died | ||
| 75, Bayles, 1975 [58]; Frean et al, 1989 [56]; Carman et al, 1989 [5] | 1975, Bayles RV 33150, IHEM 26956 (SAMN13949615) | 17, F | Lungs, skin, bone (nonvertebral) | Not done | Unknown, Survived | ||
| Uganda | 118, Jelliffe et al, 1964 [59]; Emmons et al, 1964 (case 1) [60] | 1964, Murray RV 15455, IHEM 26951, CDC B832, ATCC 56213 (SAMN13949612) | 12, M, None | Joints, skin, bone, lungs, liver, lymph nodes, kidney, spleen, thyroid. | Spherical or ovoid fungi (9–12µm) with thick-walls and single buds at broad bases. | None, Died | |
| Blastomyces emzantsi | South Africa | 69, Frean, 1993 [61]; Maphanga et al, 2020 (case 8) [14] | 1989, SA-NICD-13 (QGQJ00000000) | 40, M, None (HIV−) | Lung, vertebrae, and paravertebral abscess fistulising to skin | First interpreted as chromoblastomycosis, but on reexamination, broad-based budding yeasts resembling B. dermatitidis were seen | Amphotericin B, Died |
| 70, Frean et al, 1993 [61]; Maphanga et al, 2020 (case 9) [14] | 1993, SA-NICD-15 (QGQI00000000) | 31, M, None (HIV−) | Lung, ribs, thoracic vertebrae, subcutaneous abscesses | Yeasts resembling B. dermatitidis | Amphotericin B, Survived | ||
| 68, Frean et al, 1989 [56]; Maphanga et al, 2020 (case 10) [14] | 1975, SA-NICD-14 (QGQK00000000) | Adult, M, Severe combined immune deficiency | Skin, subcutaneous abscesses | Unknown | Unknown, Died |
Data are from patients with blastomycosis acquired in Africa or the Middle East for whom the infecting species identity is determined. For 3 additional cases of infection with B. percursus, the skin was involved but no other details are available. These include 1 case from Morocco (RV 52435/ IHEM 26957 [SAMN13949614], deposited by Rollier in 1983) and 2 from South Africa (CBS 142605/ NCPF 4091 [QGQM00000000] deposited by K. Stead in 1986; and NICD-9 [QGQF00000000] from 1978). Limited information is known for 2 cases of infection with B. gilchristii (UAMH Centre for Global Microfungal Diversity [UAMH] 10245 [EF592163] from South Africa, isolated from lung biopsy; and UAMH 10251 [EF592160] from Zimbabwe [then Rhodesia], isolated from sputum); and for 1 case of B. dermatitidis (UAMH 10246/CDC B3003 [EF592159], obtained by Vandepitte from a patient in the Democratic Republic of Congo [then Belgian Congo]).
Abbreviations: ATCC, American Type Culture Collection; CDC, Centers for Disease Control and Prevention; F, female; HIV−, documented seronegative for human immunodeficiency virus; IHEM, Belgian Coordinated Collection of Microorganisms; M, male; NCBI, National Center for Biotechnology Information.
aEach row represents 1 case, although multiple publications discussing the case or the isolate may be referenced.
bSequences are not published to NCBI, but have been published at the following website: https://www.atcc.org/products/all/56220.aspx#specifications.