Mandibular blastomycosis: A case report and review of the literature

• Published in: Germs (Bucureşti) Vol. 8; no. 4; pp. 207 - 213
• Main Authors: Albarillo, Fritzie S, Varma, Gotam T, MacLeod, Stephen P R
• Format: Journal Article
• Language: English
• Published: Romania Asociatia pentru Cresterea Vizibilitatii Cercetarii Stiintifice (ACVCS) 01.12.2018; European HIV/AIDS and Infectious Diseases Academy; Asociația pentru Creşterea Vizibilității Cercetării Ştiințifice (ACVCS)
• Subjects: Acids; Antibiotics; Antigens; Arthritis; Blastomycosis; Blood pressure; Case Report; Case reports; Epidemiology; Family medical history; Fungal infections; Health aspects; Heart rate; Infectious diseases; Pain; Illinois; mandibular osteomyelitis; mandibular blastomycosis; Blastomycosis
• ISSN: 2248-2997; 2248-2997
• DOI: 10.18683/germs.2018.1148

Blastomycosis is an endemic mycosis in the United States known to primarily cause pneumonia. However, dissemination to different organs including the musculoskeletal system has been described. We report a case of mandibular blastomycosis in a healthy patient with no evidence of lung involvement. A 28 year-old female presented with recurrent right mandibular osteomyelitis despite courses of antibiotics and surgical debridement. She eventually underwent right hemimandibulectomy. Budding yeasts visualized on Gomori Methenamine-Silver (GMS) and Periodic acid-Schiff (PAS) were morphologically consistent with and intra-operative cultures showed growth of mold identified as by DNA probe. She was placed on a prolonged course of itraconazole with clinical improvement. We also reviewed the literature and found 5 cases of similar presentation which we briefly summarized in this present case report. Blastomycosis should be considered in patients with recurrent or persistent mandibular osteomyelitis even in immunocompetent individuals.