Case Reports
Blastomyces dermatitidis Osteomyelitis of the Tibia
Am J Orthop. 2007 January;36(1):29-32
Author and Disclosure Information
Catherine L. Weber, MD, FRCPC, Debra Bartley, MD, FRCSC, Abdulhakeem Al Thaqafi, MD, and John M. Embil, MD, FRCPC
Dr. Weber is Nephrologist Department of Medicine, Section of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada.
Dr. Bartley is Fellow, Department of Surgery, Section of Orthopedics, University of Western Ontario, London Ontario, Canada.
Dr. Al Thaqafi is Consultant and Section Head, Infectious Diseases, Department of Medicine, Director, Infection Prevention and Control Department, King Abdulaziz Medical City-Western Region, National Guard Health Affairs, Saudi Arabia.
Dr. Embil is Consultant, Infectious Diseases, Department of Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract not available. Introduction provided instead.
Blastomycosis is a rare fungal infection caused by the thermally dimorphic fungus Blastomyces dermatitidis. Study of sporadic cases and outbreaks indicates that the area of endemnicity for B dermatitidis in North America includes the Ohio and Mississippi River basins and the Canadian Provinces and American states that border the Great Lakes.1-8 Blastomycosis often presents a diagnostic dilemma, having varied clinical manifestations and involving multiple sites in the body.6 A
thorough travel history and a high index of suspicion are needed when a patient presents with a chronic granulomatous infection of lung, bone, and/or soft tissue. The case that follows and the ensuing discussion highlight the difficulty in establishing the diagnosis of blastomycosis.