Central nervous system blastomycosis diagnosed using the MVista® Blastomyces quantitative antigen enzyme immunoassay test on cerebrospinal fluid: A case report and review of the literature

Walkty, Andrew; Keynan, Yoav; Karlowsky, James A.; Dhaliwal, Perry; Embil, John M.

doi:10.1016/j.diagmicrobio.2017.10.015

Cited by 13 publications

(15 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Extrapulmonary findings from hematogenous spread occur in 25% to 40% of symptomatic patients and can involve any organ system, although the most common sites are the skin, bones, genitourinary tract, and central nervous system (CNS). 2,3 Central nervous system involvement occurs in 5% to 10% of disseminated blastomycosis cases, 3,[5][6][7][8] with the majority of these patients also having active pulmonary or cutaneous involvement. 2 Isolated CNS blastomycosis is rare, with few case reports published.…”

Section: Introductionmentioning

confidence: 99%

Central Nervous System Blastomycosis With Multiple Brain Abscesses Presenting as Right Upper Extremity Weakness

Ryan

Lippert

Fenwick

et al. 2019

The Neurohospitalist

View full text Add to dashboard Cite

Blastomycosis is a mycotic infection that typically affects the lung, but that can have dermatologic, orthopedic, genitourinary, and central nervous system manifestations. Blastomyces dermatitidis is a true human pathogen, which can produce disease in immunocompetent hosts. Risk factors for infection include residence in or travel to endemic areas and outdoor occupation, particularly those activities near open bodies of water and that disrupt soil. Immunosuppressed patients are also at increased risk for severe and disseminated disease. We present a case of a 79-year-old male who presented with a 2-week history of progressive right upper extremity weakness and severe odontogenic disease. He was found to have multiple brain abscesses with positive cultures from a cerebral abscess incision and drainage for B dermatitidis. He underwent an incision and drainage of the largest cerebral abscess and was treated with intravenous liposomal amphotericin B, which he tolerated poorly. He was subsequently switched to voriconazole, which was well tolerated, and his neurological deficits improved throughout his hospitalization.

show abstract

Section: Introductionmentioning

confidence: 99%

Central Nervous System Blastomycosis With Multiple Brain Abscesses Presenting as Right Upper Extremity Weakness

Ryan

Lippert

Fenwick

et al. 2019

The Neurohospitalist

View full text Add to dashboard Cite

show abstract

“…88 There are limited data on the sensitivity of CSF antigen testing but detection is associated with disease. 89,90 The specificity of the test is poor, with cross-reactivity rates of 90 to 100% for H. capsulatum, 100% for Paracoccidioides spp., and 70% for Talaromyces marneffei. 91 Unlike with H. capsulatum, commercially available serology for B. dermatitidis is poorly sensitive and specific and not useful clinically (ID sensitivity: 33-85%, complement fixation [CF] sensitivity 33-50%).…”

Section: Diagnosismentioning

confidence: 99%

Endemic Fungi Presenting as Community-Acquired Pneumonia: A Review

Azar

Malo

Hage

2020

Semin Respir Crit Care Med

View full text Add to dashboard Cite

AbstractIn endemic areas, dimorphic fungal infections due to Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides posadasii/immitis account for up to 30% of cases of community-acquired pneumonia. Because respiratory manifestations are often indistinguishable from common bacterial causes of pneumonia, the diagnosis of pulmonary histoplasmosis, blastomycosis, and coccidioidomycosis is often delayed and associated with antibiotics overuse. In addition to being highly endemic to certain regions of North America, dimorphic fungi have global significance due to established areas of endemicity in all six inhabited continents, an increasingly interconnected world of travelers and transported goods, and a changing epidemiology as a result of global heating and anthropomorphic land utilization. In this review, we discuss the epidemiology, pathogenesis, clinical presentation, diagnostic modalities, and treatment strategies for histoplasmosis, blastomycosis, and coccidioidomycosis.

show abstract

“…40 To date, few CNS blastomycosis case reports have described the promising use of CSF Blastomyces antigen testing (MiraVista). [40][41][42] Diagnoses are often definitively made through histologic evaluation of neurosurgical or disseminated tissue biopsy samples. 5,28 Treatment of CNS blastomycosis includes lipid formulation of amphotericin B for 4 to 6 weeks for increased CNS penetration and reduced toxicity, followed by an azole as suppression therapy for at least 1 year.…”

Section: Blastomycosesmentioning

confidence: 99%

Fungal Infections of the Central Nervous System

Jia

Thakur

2019

Semin Neurol

View full text Add to dashboard Cite

Fungal central nervous system infections present in a myriad of clinical manifestation and remain a significant diagnostic challenge. Presenting symptoms, cerebrospinal fluid analysis, conventional fungal serum markers and imaging correlates of disease are seldom sensitive or specific; fungal culture growth or histopathologic analysis are often required for definitive diagnoses but limited by feasibility. Novel diagnostic tools (such as the cryptococcal antigen and next-generation sequencing) have increased diagnostic potency when available but require further studies to define their utility.Invasive fungal infections are an emerging health threat in the setting of increased immunomodulatory treatments, advancements in transplant medicine and increased world-wide travel. Therefore, strong clinical suspicion from epidemiologic clues, clinical progression and presence of CNS dissemination risk factors must be exercised to pursue broad diagnostic workups and rapidly initiate medical and surgical management. This article will describe the epidemiology, clinical presentations, diagnostic approach and therapeutic interventions for fungal infections in the central nervous system.

show abstract

Central nervous system blastomycosis diagnosed using the MVista® Blastomyces quantitative antigen enzyme immunoassay test on cerebrospinal fluid: A case report and review of the literature

Cited by 13 publications

References 19 publications

Central Nervous System Blastomycosis With Multiple Brain Abscesses Presenting as Right Upper Extremity Weakness

Central Nervous System Blastomycosis With Multiple Brain Abscesses Presenting as Right Upper Extremity Weakness

Endemic Fungi Presenting as Community-Acquired Pneumonia: A Review

Fungal Infections of the Central Nervous System

Contact Info

Product

Resources

About