A rare case of Blastomyces dermatitidis brain abscess in an immunocompetent host

Abstract

Here we present a case of a 41-year old immunocompetent female from central Maryland, who presented with new onset seizures. Magnetic resonance imaging of brain revealed a solitary ring-enhancing lesion. Stereotactic brain biopsy confirmed Blastomyces dermatitidis brain abscess. Patient's clinical course was complicated by voriconazole-induced pancytopenia that prompted surgical resection and amphothericin-induced severe hypokalemia necessitating change to high dose fluconazole. Four months after surgical resection, patient remains in radiographic and clinical remission.

Keywords

• Blastomyces dermatitidis
• Fungal brain abscess
• Dimorphic fungi
• Endemic mycoses
• Drug induced
• Pancytopenia