HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fang, W. Articles by Kumar, N. Search for Related Content PubMed PubMed Citation Articles by Fang, W. Articles by Kumar, N. Related Collections Chest Radiology

Imaging Manifestations of Blastomycosis: A Pulmonary Infection with Potential Dissemination¹

¹ From the Departments of Radiology (W.F.) and Pathology (N.K.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226; and the Department of Radiology, Duke University Medical Center, Durham, NC (L.W.). Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received June 21, 2006; revision requested August 9 and received September 22; accepted September 29. All authors have no financial relationships to disclose. Address correspondence to W.F. (e-mail: wafang{at}wi.rr.com).

Pulmonary blastomycosis is an uncommon pathologic condition that is endemic to Canada and the upper Midwest of the United States. Blastomycosis has a variety of radiologic manifestations, including airspace consolidation, focal masses, intermediate-sized nodules, interstitial disease, miliary disease, and cavitary lesions. Affected patients may be asymptomatic or may present with clinical manifestations ranging from mild chronic cough to acute respiratory distress syndrome–like symptoms. Patients with acute symptoms are more likely to have airspace consolidation, whereas chronic manifestations may be associated with masslike lesions. Intermediate-sized nodules with accompanying airspace consolidation, particularly in the upper lobes, should raise suspicion for fungal disease. Lymphadenopathy and pleural effusions are quite uncommon, and calcification is not often seen. Blastomycosis may be aggressive and require treatment. Dissemination from the lung is not unusual and can involve any organ. Diagnosis is often delayed because blastomycosis can mimic many other disease processes, including bacterial pneumonia, malignancy, and tuberculosis. Radiologists can best contribute to the care of patients who live or travel in endemic areas by maintaining a high degree of suspicion for blastomycosis and being familiar with its myriad manifestations.

© RSNA, 2007

This article has been cited by other articles:

				G. E. Wilde, C. Emery, and J. F. Lally Radiological Reasoning: Miliary Disease, Vertebral Osteomyelitis, and Soft-Tissue Abscesses Am. J. Roentgenol., March 1, 2008; 190(3_Supplement): S11 - S17. [Abstract] [Full Text] [PDF]