Blastomycosis in Ontario, 1994–2003

Morris, Shaun K.; Brophy, Jason; Richardson, Susan E.; Summerbell, Richard C.; Parkin, Patricia C.; Jamieson, Frances; Limerick, Bill; Wiebe, Lyle; El, Ford-Jones

doi:10.3201/eid1202.050849

Cited by 83 publications

(82 citation statements)

References 24 publications

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“…In Canada, B. dermatitidis occurs most commonly in northwestern Ontario. 45 The incidence of disease due to Coccidioides imitis, which is endemic to the southwestern United States and causes pulmonary, central nervous system and bone disease, may also be altered by changing rainfall, drought and temperature patterns.…”

Section: Endemic Mycosesmentioning

confidence: 99%

CMA opposes gender discrimination against doctors

Greer

Ng²,

Fisman³

2008

Canadian Medical Association Journal

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Section: Endemic Mycosesmentioning

confidence: 99%

CMA opposes gender discrimination against doctors

Greer

Ng²,

Fisman³

2008

Canadian Medical Association Journal

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“…Aerosolization of spores occurs more readily from dry soil that is disturbed (2). Due to changing climatic conditions (i.e., rainfall, temperature and humidity) and the effects on soil composition (i.e., pH and organic content), isolating B. dermatitidis from the environment can be challenging (2,3,6).…”

Section: Introductionmentioning

confidence: 99%

Blastomycosis hospitalizations in northwestern Ontario: 2006–2015

Litvinjenko

Lunny

2017

Canada Communicable Disease Report

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“…In Ontario, the north has the highest annual incidence (2.44 cases/100 000 population), and the Toronto area has the second highest annual incidence (0.26 cases/100 000 population). 11 The central east region of the province has an annual incidence rate of 0.08 cases per 100 000 population. 11 The high incidence rates in Toronto could reflect autochthonous acquisition (primary infection occurring in Toronto) or diagnoses within the Toronto area with acquisition of the fungus elsewhere.…”

Section: Epidemiologymentioning

confidence: 99%

“…11 The central east region of the province has an annual incidence rate of 0.08 cases per 100 000 population. 11 The high incidence rates in Toronto could reflect autochthonous acquisition (primary infection occurring in Toronto) or diagnoses within the Toronto area with acquisition of the fungus elsewhere. It is possible that our patient acquired his infection at either his cottage or at his home.…”

Section: Epidemiologymentioning

confidence: 99%

A breast mass in a 56-year-old man

MacFadden¹,

Gold²,

Richardson³

et al. 2011

Canadian Medical Association Journal

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A 56-year-old man living in Toronto, Ontario, presented to his family physician after finding a lump in his right breast on self-inspection. He described a onemonth history of pressure and tenderness at the site of the mass. No other lumps were detected, and there was no history of fever, sweats, weight loss or previous trauma to the breast. He had a history of obstructive sleep apnea, took no medications and did not use recreational or injection drugs. The patient had no relevant family history and no contacts with people who were ill. His history of travel was limited to his cottage in central Ontario.On examination, a 3-cm mass that extended medially was palpable in the retroareolar area of the patient's right breast. The mass was rubbery, nontender and did not appear to be tethered to the overlying skin, which was intact. No axillary lymph adenopathy was detected. The left breast and the remainder of the general examination were normal. What is the most common cause of a breast mass in a man?a. Gynecomastia b. Breast carcinoma c. Benign fibrocystic changes d. Inflammatory/infectious diseases of the breast e. Lymphoma Gynecomastia is the most common cause of combined unilateral and bilateral breast mass(es) in men (Box 1).1-4 Clinically, gynecomastia usually presents as a concentric retroareolar rubbery mass. 4 This patient's mass was atypical of gynecomastia as it extended medially in an asymmetric fashion. Given the possibility of a malignant cause, the patient was referred for further evaluation to a rapid diagnostic clinic for breast cancer.At the clinic, the patient received a mammogram, ultrasonography and a core biopsy of the mass. Mammography showed a well-defined 2.5-cm mass located within the right breast (Figure 1). No calcifications were present. Ultrasonography confirmed these findings and did not detect any substantial regional lymphadenopathy. A core biopsy and tissue staining suggested a fungal cause (Figure 2 and Appendix 1, available at www.cmaj .ca /lookup /suppl /doi :10 .1503 /cmaj .110953/-/DC1.), but no specimen was sent for culture. Based on the results of the biopsy, the patient was referred to an outpatient clinic for infectious diseases for further evaluation and management of the condition. What is your call?A breast mass in a 56-year-old man

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Blastomycosis in Ontario, 1994–2003

Abstract: Clinicians in Ontario should be aware of symptoms and areas where disease is endemic.

Cited by 83 publications

References 24 publications

CMA opposes gender discrimination against doctors

CMA opposes gender discrimination against doctors

Blastomycosis hospitalizations in northwestern Ontario: 2006–2015

A breast mass in a 56-year-old man

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