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Intramedullary Blastomycosis in a Child: Case Report

Published online by Cambridge University Press:  16 February 2016

A.M. Parr  and
D. Fewer
A.M. Parr
Affiliation:
Division of Neurosurgery, University of Manitoba, WinnipegMB, Canada
D. Fewer*
Affiliation:
Division of Neurosurgery, University of Manitoba, WinnipegMB, Canada
*
713-39 Parliament St., Toronto, ON M5A4R2,Canada.
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Abstract

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Objective:

To report a case of spinal intramedullary blastomycosis causing myelopathy. This is the first published case of a pediatric patient with intramedullary blastomycosis and compromised function.

Clinical presentation:

An otherwise healthy 13-year-old patient was diagnosed with respiratory North American blastomycosis. She subsequently received a five-month course of itraconazole with presumed resolution of the infection. The patient presented again at 14 years of age with a lumbar myelopathy. Magnetic resonance imaging revealed an intramedullary lesion of 1 cm diameter at the level of T12-L1.

Intervention:

AT12-L1 laminectomy was performed with a gross total resection of the lesion. Pathological examination and microbiological culture of the specimen was consistent with blastomycosis. Postoperatively, the patient was placed on a five week course of amphotericin B. The patient showed substantial improvement in neurological function.

Conclusion:

Blastomycosis can present as an isolated intramedullary lesion causing compromised function. It should be considered in the differential diagnosis of a patient with a myelopathy and previously recognized blastomycosis. The prognosis is good with surgical resection.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 282 - 285
Copyright
Copyright © The Canadian Journal of Neurological 2004

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