Siblings in the ICU: Keeping Endemic Mycoses on the Differential
Abstract
Blastomycosis is a rare fungal infection caused by the inhalation of Blastomyces dermatitidis spores. Infection with this fungus can impact nearly every organ system, though pulmonary disease is the most common. Presentations of pulmonary blastomycosis are highly variable, ranging from clinically asymptomatic to severe respiratory failure requiring intensive care. This case series describes the clinical presentation, diagnostic challenges, management, and outcomes of two siblings with severe pulmonary blastomycosis that progressed to pediatric acute respiratory distress syndrome requiring mechanical ventilation and venovenous extracorporeal membrane oxygenation (VV-ECMO). Despite being relatively uncommon, blastomycosis should be considered in patients with respiratory symptoms not responding to empiric antibacterial therapy, particularly in endemic regions. Early diagnosis and prompt initiation of appropriate antifungal therapy are crucial for favorable outcomes. Additionally, early initiation of ECMO for severe pulmonary blastomycosis may be beneficial in temporizing to allow time for sufficient response to antifungal therapy.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.