Intensive Care Unit and Hospital Outcomes of Patients Admitted with Blastomycosis: A 14-Year Retrospective Study

Abstract

Introduction: Blastomycosis is an uncommon; potentially life threatening granulomatous fungal infection. The aim of this study is to report hospital and intensive care unit (ICU) outcomes of patients admitted with blastomycosis.Methods: All patients admitted for treatment of blastomycosis at the Mayo Clinic-Rochester, Minnesota between 01/01/2006 and 09/30/2019 were included. Demographics, comorbidities, clinical presentation, ICU admission, and outcomes were reviewed.Results: A total of 84 Patients were identi ed with 93 unique hospitalizations primarily for blastomycosis. The median age at diagnosis was 49 (IQR 28.1-65, range: 6-85) years and 56 (66.7%) were male. The most frequent comorbidities incl uded hypertension (n=28, 33.3%); immunosuppressed state (n=25, 29.8%) and diabetes mellitus (n=21, 25%). The lungs were the only organ involved in 56 (66.7%) cases and the infection was disseminated in 19 (22.6%) cases.A total of 29 patients (34.5%) underwent ICU admission due to complications of blastomycosis. ICU related events included mechanical ventilation (n=21, 25%), acute respiratory distress syndrome (ARDS) (n=13, 15.5%), tracheostomy (n=9, 10.7%), renal replacement therapy (n=8, 9.5%), and extracorporeal membrane oxygenation (ECMO) (n=4, 4.8%). A total of 12 patients (14.3%) died in the hospital; all of whom had undergone ICU admission. In-hospital mortality was associated with renal replacement therapy (RRT) (P=0.0255).Conclusions: Blastomycosis is a serious, potentially life-threatening infection that results in signi cant morbidity and mortality with a 34.5% ICU admission rate. Renal replacement therapy was associated with in-hospital mortality.

LUNG Year in Review: 2022

“…The journal remained very selective in accepting COVID-19 related submissions, publishing only two particularly significant articles comparing virulence among SARS-CoV-2 variants [ 82 ] and evaluating pandemic-associated cough [ 54 ]. Other notable publications in the area of infectious disease included a State-of-the-Art review of Strongyloides stercoralis [ 83 ], an outcome analysis of Blastomycosis infections [ 84 ], and an investigation of cytomegalovirus (CMV) infection in lung transplant recipients [ 85 ].…”