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Case Reports in Medicine
Volume 2014, Article ID 514382, 5 pages
Case Report

Rapid Progression of Pulmonary Blastomycosis in an Untreated Patient of Chronic Lymphocytic Leukemia

1Divisions of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL 32608, USA
2Pulmonary and Critical Care Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
3Ben Taub General Hospital, 1504 Taub Loop, BTGH-6PF80002, Houston, TX 77030, USA

Received 21 January 2014; Revised 1 March 2014; Accepted 17 March 2014; Published 13 April 2014

Academic Editor: Masahiro Kohzuki

Copyright © 2014 Pralay K. Sarkar et al. 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.


Chronic lymphocytic leukemia (CLL) is associated with a state of immunosuppression characterized by hypogammaglobulinemia as well as B and T lymphocyte dysfunction. Though opportunistic infections are common in CLL patients, particularly after treatment, reports of infections by endemic dimorphic fungi are very few. Here we report a case of pulmonary blastomycosis in a CLL patient who initially presented with an indolent pulmonary mass lesion. The pulmonary lesions progressed rapidly over a two-week period. The diagnosis was established by transbronchial lung biopsy. He was treated with Amphotericin B lipid complex followed by oral itraconazole and recovered uneventfully. This case illustrates the importance of a timely diagnosis and treatment. The presentation of blastomycosis in immunocompromised patients, diagnosis, and treatment are discussed.