The Blastomycosis Bluff by Purpureocillium lilacinum

A 73-year-old patient with a history of rheumatoid arthritis and inclusion body myositis on long-term prednisone and azathioprine presented with a 3-month history of tender erythematous nodules on his right lower extremity (Figure  1). A skin biopsy revealed yeast forms with broad-based budding yeast (Figure 2, [arrow]). Initially, a diagnosis of cutaneous blastomycosis was made, and he was initiated on itraconazole. However, (1-3)-β-d-glucan assay was elevated at>500 pg/mL (reference range:

Source: Mayo Clinic Proceedings - March 31, 2019 Category: Internal Medicine Authors: Zachary T. Lundstrom, Omar M. Abu Saleh Tags: Medical images Source Type: research