Osteomyelitis caused by concurrent infection with Mycobacterium tuberculosis and Blastomyces dermatitidis.
1974; National Institutes of Health; Volume: 109; Issue: 2 Linguagem: Inglês
10.1164/arrd.1974.109.2.286
AutoresMichael F. Rein, J L Fischetti, Merle A. Sande,
Tópico(s)Actinomycetales infections and treatment
ResumoThe clinical and radiologic appearance of pulmonary and skeletal tuberculosis may be so similar to that of North American blastomycosis that identification of the organism by morphology or culture is needed to differentiate between them. Many reported cases of blastomycosis have been diagnosed on the basis of the combination of a typical pulmonary shadow and the culture of Blastomyces dermatitidis from a distant lesion, usually the skin. The present case emphasizes that this approach may miss a double infection, since the second pathogen, in this case Mycobacterium tuberculosis, may be limited in distribution to only certain lesions. The “classical” case of North American blastomycosis or tuberculosis in which the patient presents with slightly unusual findings or responds only partially or inappropriately to antimicrobials should be considered as a potential double infection, and an intensive search for a second pathogen is indicated.
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