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Canadian Journal of Infectious Diseases
Volume 13, Issue 4, Pages 259-263
http://dx.doi.org/10.1155/2002/906757
Case Report

Blastomyscosis Acquired by Three Children in Toronto

Stacey Bernstein,1,5 Hermine I Brunner,1,5 Richard Summerbell,4,5 Upton Allen,1,5 Paul Babyn,2,5 and Susan E Richardson3,5

1Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
2Department of Radiology, The Hospital for Sick Children, Toronto, Canada
3Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
4Laboratory Branch, Ontario Ministry of Health and Long Term Care, Canada
5The University of Toronto, Toronto, Ontario, Canada

Received 14 September 2001; Revised 20 December 2001

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Three paediatric cases of blastomycosis, apparently acquired in or near Toronto, Ontario, a region not known to be endemic for this disease, are described. Blastomycosis was not suspected clinically in any of the three cases, and the diagnosis was established only when the diagnostic net was broadened to include fungal and mycobacterial cultures. All three patients were diagnosed after significant delays, which is consistent with the rarity of the disease in children and its acquisition outside previously accepted geographical boundaries. Pulmonary involvement was present in all three children, while one also had multifocal osteomyelitis. Drug therapy was successful in all three cases, either with amphotericin B followed by itraconazole, or itraconazole alone. Blastomycosis should be included in the differential diagnosis of a patient from the Toronto area who presents with a compatible history despite a negative travel history to known endemic zones.