Pulmonary blastomycosis as an occupational disease. Presentation of an unrecognized case / Blastomicosis pulmonar como enfermedad de trabajo. Presentación de un caso no dictaminado como profesional

Resumen

Introduction: Blastomycosis is a granulomatous infectious disease, caused by the dimorphic fungus Blastomyces dermatitidis. It predominates in the United States of America and in Mexico only 6 imported systemic cases have been reported.

Objective: We present the case of a 41-year-old man, originally from Mexico City, because of his work, he traveled to the United States of America for 10 years, he began current suffering with the presence of recurrent pneumonic pictures that partially responded to treatment based on antibiotics with multiple hospitalizations.

Methods: An analysis was carried out of a case that presented itself to the service in 2000, which was denied as a Work Illness since the IMSS did not recognize work illnesses 20 years ago.

Results: Macroscopic report of the upper and middle right lobe with extensive areas of emphysema, areas of atelectasis, multiple granulomas, within them, retractile thick-walled spherical structures with small structures inside, multiple granulomatous lesions with central caseous necrosis, the periphery of granulomas with a tendency to hyalinization, abundant PMN, and histiocytes with anthracosis, mixed with lymphocytes. with PAS, Grocott, Gridley and Cong red stains. Chronic pulmonary blastomycosis is diagnosed with all of the above. Treatment with itraconazole at a dose of 200 mg / d for 2 months was indicated with a clinical and mycological cure.

Conclusions: The case presented could be considered the first to be recognized as an occupational disease due to the association between the exposure and the demonstrated presence of the pathology.