Open AccessDisseminated blastomycosis presenting as a retro-orbital mass
Author(s) -
Shan Murawski,
Michael Farrell,
Fernanda Cordeiro-Rudnisky,
Richard Blinkhorn
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228681
Subject(s) - medicine , blastomyces dermatitidis , blastomycosis , itraconazole , amphotericin b , soft tissue , blastomyces , surgery , biopsy , pneumonia , radiology , dermatology , antifungal
A 43-year-old man with history of non-Hodgkins' lymphoma presented with unilateral eye swelling, pain and vision deficits which had been progressive over 2 months. Symptoms followed a presumed bacterial pneumonia 4 months prior. Imaging demonstrated retro-orbital soft tissue swelling with bony erosion concerning for a mass; surgical decompression was performed with histology confirming disseminated Blastomyces dermatitidis Symptoms responded rapidly to antifungal therapy with amphotericin followed by itraconazole. Orbital dissemination of blastomycosis is extremely rare; accurate diagnosis requires tissue biopsy to facilitate timely targeted therapy and minimise morbidity.