A rare fatal case of disseminated cutaneous blastomycosis in a child

Abstract

We report a rare fatal case of disseminated blastomycosis in an otherwise healthy 12-year-old child. He presented with multiple verrucous, hyperkeratotic suppurating plaques, and multiple sinuses discharging thick pus over the face, chest, and upper and lower limbs for the last 8 months. Clinical diagnosis was confirmed by histopathology which showed thick-walled, clustered refractile yeast cells with broad-based unidirectional budding resembling hyphae. Although he was vigorously treated by intravenous amphotericin-B and itraconazole, the child succumbed to death within 2 weeks of presentation. This case is being reported for its rarity and fatal outcome. Besides, in the present case, widespread cutaneous spread occurred without any other systemic involvement.

Keywords

• Cutaneous blastomycosis
• deep fungal infection
• itraconazole