Adam Austin1, Ellis Tobin2, Marc A Judson3, Chadi A Hage4, Kurt Hu5, Oleg Epelbaum6, John Fantauzzi7, David M Jones8, Shelley Gilroy9, Amit Chopra3. 1. Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL. Electronic address: adam.austin@medicine.ufl.edu. 2. Upstate Infectious Diseases Associates, Albany, NY; Department of Medicine, Albany Medical College, Albany, NY. 3. Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY. 4. Division of Pulmonary, Critical Care and Sleep Medicine, Indiana University-School of Medicine, Indianapolis, IN. 5. Division of Pulmonary, Critical Care and Sleep Medicine, Medical College of Wisconsin, Milwaukee, WI. 6. Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY. 7. Department of Radiology, Albany Medical College, Albany, NY. 8. Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY. 9. Department of Medicine, Albany Stratton Veterans Affairs Medical Center, Albany, NY.
Abstract
BACKGROUND: The Centers for Disease Control and Prevention and New York State Department of Health recently identified the Capital District of New York (CDNY) as an emerging endemic area for blastomycosis. However, no clinical or epidemiological description of blastomycosis in the CDNY has been published. METHODS: We performed a retrospective analysis of blastomycosis cases at Albany Medical Center (AMC) and Albany Stratton Veterans Affairs Medical Center (VAMC) from January 1, 2000, through June 1, 2019. Patients were identified via an institution-approved informatics system at the hospital's microbiology laboratory. RESULTS: We identified 20 patients diagnosed with blastomycosis over the past 2 decades. There was a nearly 9-fold increase in the annual number of cases in 2016-2019 compared with 2000-2015. The majority of patients resided in the CDNY (90%), and 65% lived within the Mohawk River valley. Most cases (85%) were assumed to be malignancies or non-mycotic infections prior to diagnosis, with median time between presentation and diagnosis of 53 days. CONCLUSIONS: Our data support recent reports that blastomycosis is an emerging disease in the CDNY. Most patients were misdiagnosed as malignancy or non-mycotic infection, which led to treatment delays.
BACKGROUND: The Centers for Disease Control and Prevention and New York State Department of Health recently identified the Capital District of New York (CDNY) as an emerging endemic area for blastomycosis. However, no clinical or epidemiological description of blastomycosis in the CDNY has been published. METHODS: We performed a retrospective analysis of blastomycosis cases at Albany Medical Center (AMC) and Albany Stratton Veterans Affairs Medical Center (VAMC) from January 1, 2000, through June 1, 2019. Patients were identified via an institution-approved informatics system at the hospital's microbiology laboratory. RESULTS: We identified 20 patients diagnosed with blastomycosis over the past 2 decades. There was a nearly 9-fold increase in the annual number of cases in 2016-2019 compared with 2000-2015. The majority of patients resided in the CDNY (90%), and 65% lived within the Mohawk River valley. Most cases (85%) were assumed to be malignancies or non-mycotic infections prior to diagnosis, with median time between presentation and diagnosis of 53 days. CONCLUSIONS: Our data support recent reports that blastomycosis is an emerging disease in the CDNY. Most patients were misdiagnosed as malignancy or non-mycotic infection, which led to treatment delays.
Authors: Hiroshi Sogawa; Ryosuke Misawa; Roxana Bodin; David C Wolf; Rajat Nog; George Kleinman; Seigo Nishida; Oleg Epelbaum Journal: Med Mycol Case Rep Date: 2022-08-10