Isolated blastomycosis hand infections are extremely rare, and are often clinically
unsuspected, leading to delays in clinical diagnosis. Conclusive diagnosis often necessitates
fungal cultures and histopathological demonstration of budding yeasts in tissues.
In this report, we describe the rare occurrence of isolated blastomycotic hand infection,
without any other organ involvement, in a 42-year-old male patient. Analyzing tissue
specimens with frozen section has been shown in the past to demonstrate granulomatous
inflammation and yeast forms of the organism; however, as demonstrated in this patient,
the presence of pseudoepitheliomatous cells may deceptively appear as malignant, causing
substantial concern and anxiety. Definitive diagnosis often necessitates fungal culture
and histopathological examination with special fungal stains including polymerase
chain reaction for speciation.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Blastomycosis.Infect Dis Clin North Am. 2016; 30: 247-264
- Unusual osseous presentation of blastomycosis in an immigrant child: a challenge for European pediatricians.Ital J Pediatr. 2012; 38: 69
- Radiologic case study. Blastomycosis of bone.Orthopedics. 2011; 34: 409-486
- Blastomycosis of bones and joints.South Med J. 2007; 100: 570-578
- Pediatric blastomycotic osteomyelitis of the hand.Hand (NY). 2012; 7: 442-446
- Blastomycosis of bone. A report of six cases.J Bone Joint Surg Am. 1982; 64: 1097-1101
- Blastomyces tenosynovitis of the foot and ankle: a case report and review of the literature.J Foot Ankle Surg. 2015; 54: 1183-1187
- Blastomycosis of the temporal bone mimicking glomus jugulare tumor.Otol Neurotol. 2016; 37: e173-e175
- Blastomycosis: case report of an isolated lesion in the distal fibula.Am J Orthop (Belle Mead NJ). 2010; 39: E22-E24
- Blastomycosis of long bones.Clin Orthop Relat Res. 2004; : 255-259
- Delayed diagnosis of osseous blastomycosis in two patients following environmental exposure in nonendemic areas.Am J Clin Pathol. 2002; 118: 536-541
- Simulators of squamous cell carcinoma of the skin: diagnostic challenges on small biopsies and clinicopathological correlation.J Skin Cancer. 2013; 2013: 752864
- Heterogeneity of blastomycosis-like pyoderma: a selection of cases from the last 35 years.Australas J Dermatol. 2017; 58: 139-141
- Blastomycosis of bone: a clinicopathologic study.Am J Clin Pathol. 2014; 142: 609-616
- Blastomycotic hand infections.Scand J Plast Reconstr Surg Hand Surg. 2009; 43: 166-170
- Laryngeal carcinoma—or is it laryngeal blastomycosis.Laryngoscope. 1984; 94: 608-611
- Blastomycosis of the eyelid.Arch Ophthalmol. 1986; 104: 96-97
- Sweet's syndrome-like blastomycosis.Am J Dermatopathol. 2003; 25: 152-154
- Pulmonary blastomycosis.Semin Respir Crit Care Med. 2011; 32: 745-753
- Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America.Clin Infect Dis. 2008; 46: 1801-1812
- Successful treatment of osseous blastomycosis without pulmonary or disseminated disease and review of the literature.Diagn Microbiol Infect Dis. 2014; 79: 242-244
- Successful use of posaconazole for treatment of blastomycosis.Antimicrob Agents Chemother. 2012; 56: 4029
Article info
Publication history
Published online: June 29, 2017
Accepted:
May 24,
2017
Received:
January 9,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
