CTICasesBlastomycosis Empyema
Imaging findings
Serial chest radiographs in an 8-year-old girl show progressive, unresolving right lobar consolidation that rapidly develops a large pleural effusion and right paratracheal lymphadenopathy. Chest CT demonstrates a complex, loculated right empyema with subpleural necrotizing pneumonia and a bronchopleural fistula, leading to persistent pneumothorax and subcutaneous emphysema despite tube thoracostomy.
Key takeaways
Although pleural effusion and bulky lymphadenopathy are classically associated with bacterial or histoplasmosis infections and are considered atypical for blastomycosis, blastomycosis can occasionally present as a severe, necrotizing pneumonia complicated by empyema and bronchopleural fistula, particularly in pediatric patients. DNA probe testing on bronchial washings or pleural fluid can aid in prompt diagnosis when standard cultures are negative.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Disseminated BlastomycosisInfection
- Tattoo Ink LymphadenopathyExposure
- BroncholithiasisInflammatory
- Patent Foramen OvaleCongenital
- Familial Nonspecific Interstitial PneumoniaILD
- Sulfur Dioxide InhalationExposure
- Esophageal LeiomyomaNeoplastic
- Esophagobronchial FistulaIatrogenic
See all cases from November 17, 2017 →