Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology

Among fungal infections, fungal empyema (FE) is rare and has significant mortality. Microscopic examination of the pleural fluid plays an essential role in its diagnosis. Since pleural fluid can be obtained easily as a bedside procedure, yielding significant diagnostic material, other invasive and e...

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Main Authors: Mayur Ambekar, Archana C. Buch, Mangesh Londhe
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Medical Journal of Dr. D.Y. Patil Vidyapeeth
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Online Access:https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_773_23
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author Mayur Ambekar
Archana C. Buch
Mangesh Londhe
author_facet Mayur Ambekar
Archana C. Buch
Mangesh Londhe
author_sort Mayur Ambekar
collection DOAJ
description Among fungal infections, fungal empyema (FE) is rare and has significant mortality. Microscopic examination of the pleural fluid plays an essential role in its diagnosis. Since pleural fluid can be obtained easily as a bedside procedure, yielding significant diagnostic material, other invasive and expensive procedures can be avoided. The fungal elements identified in FE on microscopy can be yeasts, filamentous fungi, and dimorphic fungi. The morphology of spherical, thick-walled yeast cells showing broad-based budding is commonly seen in blastomycosis, coccidioidomycosis, and cryptococcosis. Though microbiological tests remain the gold standard, pleural fluid cytology with various special stains can be used as a rapid, reliable test for diagnosis. This has the advantages of prompt diagnosis, minimum expertise, and cost-effectiveness. We present a case of a 75-year-old male who presented with bilateral pleural effusion, the cytology of which revealed blastomycosis.
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spelling doaj-art-d85fe6cc741a47159858ae2b500fbe372025-08-20T01:59:08ZengWolters Kluwer Medknow PublicationsMedical Journal of Dr. D.Y. Patil Vidyapeeth2589-83022589-83102024-11-0117Suppl 2S394S39610.4103/mjdrdypu.mjdrdypu_773_23Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on CytologyMayur AmbekarArchana C. BuchMangesh LondheAmong fungal infections, fungal empyema (FE) is rare and has significant mortality. Microscopic examination of the pleural fluid plays an essential role in its diagnosis. Since pleural fluid can be obtained easily as a bedside procedure, yielding significant diagnostic material, other invasive and expensive procedures can be avoided. The fungal elements identified in FE on microscopy can be yeasts, filamentous fungi, and dimorphic fungi. The morphology of spherical, thick-walled yeast cells showing broad-based budding is commonly seen in blastomycosis, coccidioidomycosis, and cryptococcosis. Though microbiological tests remain the gold standard, pleural fluid cytology with various special stains can be used as a rapid, reliable test for diagnosis. This has the advantages of prompt diagnosis, minimum expertise, and cost-effectiveness. We present a case of a 75-year-old male who presented with bilateral pleural effusion, the cytology of which revealed blastomycosis.https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_773_23fungusmicroscopypleural fluidspecial stains
spellingShingle Mayur Ambekar
Archana C. Buch
Mangesh Londhe
Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
Medical Journal of Dr. D.Y. Patil Vidyapeeth
fungus
microscopy
pleural fluid
special stains
title Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
title_full Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
title_fullStr Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
title_full_unstemmed Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
title_short Blastomycosis: A Rare Cause of Pleural Effusion, Diagnosed on Cytology
title_sort blastomycosis a rare cause of pleural effusion diagnosed on cytology
topic fungus
microscopy
pleural fluid
special stains
url https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_773_23
work_keys_str_mv AT mayurambekar blastomycosisararecauseofpleuraleffusiondiagnosedoncytology
AT archanacbuch blastomycosisararecauseofpleuraleffusiondiagnosedoncytology
AT mangeshlondhe blastomycosisararecauseofpleuraleffusiondiagnosedoncytology