Title

Unusual presentation of pulmonary blastomycosis complicated by amphotericin-induced refractory electrolyte abnormalities

Affiliations

Department of Medicine, Advocate Illinois Masonic Medical Center

Department of Medicine, Advocate Illinois Masonic Medical Center

Department of Medicine, Advocate Illinois Masonic Medical Center

Department of Infectious Diseases, Advocate Illinois Masonic Medical Center

Abstract

Blastomyces dermatitidis is an endemic mold infection commonly seen in the midwestern of the USA and rarely affects pregnant women. The most common presentation is a pulmonary infection with variable degrees of severity. Of note, the clinical and radiographic findings of pulmonary blastomycosis can be mistaken for other pulmonary pathologies, thus earning the title of 'the great pretender'. The treatment of choice of infected pregnant patients is amphotericin B, which is known to produce electrolyte imbalances. However, it infrequently causes severe, prolonged and profound hypokalemia and hypomagnesemia. We present the case of a 27-year-old pregnant patient with pulmonary blastomycosis presenting with a lung mass suspicious of malignancy and treated with amphotericin B with subsequent prolonged refractory hypokalemia and hypomagnesemia. Keywords pulmonary blastomycosis pregnancy biopsy computed tomography angiography liposomal amphotericin B.

Document Type

Article

PubMed ID

33269079

DOI

10.1093/omcr/omaa093

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