Blastomycosis in India: report of an imported case and current status

We report a case of disseminated blastomycosis in a female resident of Delhi, who acquired the infection during travel to the USA, which was successfully treated with oral itraconazole. In addition, we present a critical literature review, indicating that blastomycosis is endemic in India but its ar...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2013-02, Vol.51 (2), p.185-192
Main Authors: Randhawa, Harbans S., Chowdhary, Anuradha, Kathuria, Shallu, Roy, Pradip, Misra, Deepti S., Jain, Sarika, Chugh, Tulsi D.
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Antifungal Agents - administration & dosage
Antifungal Agents - pharmacology
Base Sequence
Blastomyces - drug effects
Blastomyces - genetics
Blastomyces - isolation & purification
Blastomycosis - microbiology
Blastomycosis - pathology
DNA, Fungal - chemistry
DNA, Fungal - genetics
DNA, Ribosomal Spacer - chemistry
DNA, Ribosomal Spacer - genetics
Female
Genes, Fungal - genetics
Humans
Hyphae
India
Itraconazole - administration & dosage
Itraconazole - pharmacology
Microbial Sensitivity Tests
Molecular Sequence Data
Promoter Regions, Genetic - genetics
Sequence Analysis, DNA
Spores, Fungal
Travel
United States
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Summary:We report a case of disseminated blastomycosis in a female resident of Delhi, who acquired the infection during travel to the USA, which was successfully treated with oral itraconazole. In addition, we present a critical literature review, indicating that blastomycosis is endemic in India but its areas of endemicity, prevalence, and the natural habitat of the etiologic agent, remain undetermined. The diagnosis of blastomycosis was made by examination of Gomori's methenamine silver stained sections of tissue obtained from a biopsy of a subcutaneous, abdominal nodular. These studies revealed thick-walled, broad-based budding yeast cells compatible with Blastomyces dermatitidis, and consistent with the isolation of the fungus in cultures inoculated with posterior auricular lymph node aspirate. Microscopically, the isolate had thin, septate hyphae and characteristic spherical to pyriform, smooth-walled microconidia. Its identity was confirmed by conversion to its typical yeast form on pea seed agar at 37°C and by DNA sequencing of ITS and BAD 1 promoter regions.
ISSN:1369-3786
1460-2709
DOI:10.3109/13693786.2012.685960