Direct Tissue PCR and Genotyping for Species Identification in a Case of Laryngeal Blastomycosis

Ear Nose Throat J. 2023 Apr;102(4):NP157-NP160. doi: 10.1177/0145561321991342. Epub 2021 Mar 8.

Abstract

Otolaryngologic manifestations of infection with Blastomyces species are extremely rare and restricted geographically to recognized endemic regions. Here, we describe a case of laryngeal blastomycosis that presented as slowly progressive dysphonia. While a preliminary diagnosis was made using routine histopathology, a species identification of Blastomyces dermatitidis was made using polymerase chain reaction amplification and rapid genotyping without the need for fungal culture. All symptoms resolved following 1 month of antifungal therapy. Rapid molecular differentiation of B dermatitidis from Blastomyces gilchristii provides important insights into pathogenesis given recent recognition of differences in clinical spectra.

Keywords: Blastomyces dermatitidis; blastomycosis; fungal laryngitis; laryngeal.

Publication types

  • Case Reports

MeSH terms

  • Blastomyces / genetics
  • Blastomycosis* / diagnosis
  • Blastomycosis* / drug therapy
  • Blastomycosis* / pathology
  • Genotype
  • Humans
  • Larynx* / pathology
  • Polymerase Chain Reaction