Pulmonary blastomycosis presenting as primary lung cancer.

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Hussaini, Syed Mohammed Qasim
Madut, Deng
Tong, Betty C
Pavlisko, Elizabeth N
Schell, Wiley A
Perfect, John R
Thielman, Nathan M

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BACKGROUND:Blastomycosis is an endemic mycosis in North America that is caused by the dimorphic fungus Blastomyces dermatitidis. The illness is a systemic disease with a wide variety of pulmonary and extra-pulmonary manifestations. The initial presentation of blastomycosis may easily be mistaken for other infectious or non-infectious etiologies. CASE PRESENTATION:We present the case of a 52-year-old African-American male and former smoker that presented to his primary care provider with a 2-week history of non-productive cough, night sweats and weight loss. Initially diagnosed with primary lung malignancy, the patient was subsequently found to have pulmonary blastomycosis mimicking lung cancer. The patient underwent a successful course of treatment with posaconazole. CONCLUSIONS:Chronic blastomycosis can present with clinical and radiographic features indistinguishable from thoracic malignancies. There is no clinical syndrome specific for blastomycosis, thus a high degree of suspicion is required for early diagnosis. In this case report, we review recent evidence in radiographic features, diagnostic considerations and treatment of the disease.





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Hussaini, Syed Mohammed Qasim, Deng Madut, Betty C Tong, Elizabeth N Pavlisko, Wiley A Schell, John R Perfect and Nathan M Thielman (2018). Pulmonary blastomycosis presenting as primary lung cancer. BMC infectious diseases, 18(1). p. 336. 10.1186/s12879-018-3244-0 Retrieved from https://hdl.handle.net/10161/18966.

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Syed Hussaini

House Staff

Deng Madut

Assistant Professor of Medicine

I am an infectious diseases doctor who specializes in the care of patients with general infectious diseases, including persons living with HIV. My research is focused on improving the diagnosis and treatment of infectious diseases among populations living in low-resource settings.


Betty Caroline Tong

Associate Professor of Surgery

Elizabeth N Pavlisko

Associate Professor of Pathology

Dr. Pavlisko holds an undergraduate degree in Biochemistry from Clemson University and received her Doctor of Medicine from the Medical University of South Carolina. She completed her residency and is board certified in both Anatomic and Clinical Pathology. She trained as a pulmonary/thoracic pathology fellow at Duke University Medical Center under the mentorship of Drs. Victor Roggli and Thomas Sporn, two of the world’s leading Pulmonary Pathologist with expertise in pneumoconiosis and mesothelioma. She joined the faculty at Duke in 2011 as an Assistant Professor of Pathology, and her work is focused in thoracic, cardiovascular and transplant pathology as well as postmortem examination. Since starting her independent position, Dr. Pavlisko has developed expertise in neoplastic and non-neoplastic diseases of the lung and mediastinum with a special interest in lung transplantation and diseases of the pleura for which she is widely recognized as an authority. She currently serves as Chief of the Pulmonary/Thoracic Pathology Section.  

Dr. Pavlisko’s clinical activities encompass pulmonary/thoracic and cardiovascular pathology, including transplantation, biomarker testing and autopsy pathology. Her primary research focus has centered on malignant mesothelioma and chronic lung allograft dysfunction (CLAD). She has published over 40 manuscripts and has 6 book chapters, the latter all centered on occupational diseases of the lungs and pleura. Since 2017, Dr. Pavlisko has co-chaired the lung steering committee for the Banff Foundation for Allograft Pathology. She is also an active member of the International Society for Heart and Lung Transplantation. Dr. Pavlisko has collaborations with the Departments of Pulmonary, Allergy and Critical Care Medicine and Cardiothoracic Surgery.

In addition to her clinical and research activities, Dr. Pavlisko is active in Duke University Hospital’s Clinical Laboratories and currently serves as the Associate Medical Director of the Division of Anatomic Pathology and Digital Analytics (DAPDA), which includes leadership roles in the Immunopathology Laboratory as well as Image Cytometry Laboratory.

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