REACTIVATION AND DISSEMINATION OF BLASTOMYCOSIS COMPLICATING HODGKINS-DISEASE - A CASE-REPORT AND REVIEW OF THE LITERATURE

Patients presenting with Hodgkin's disease (HD) may show lung involvem ent characterized by contiguous spread from ipsilateral hilar lymph no des. Lung consolidation or noncontiguous pulmonary involvement makes a n alternative diagnosis more likely. This report describes a patient w ith HD in whom concurrent pulmonary blastomycosis was recognized only after chemotherapy had started and dissemination had occurred. Althoug h Blastomyces dermatitidis may behave as an opportunitist pathogen, th ere are no previous reports of blastomycosis in patients with HD. Undi agnosed active opportunistic infection at the time of diagnosis of HD may complicate staging as well as treatment. Biopsy of lung lesions wi th stain and culture for opportunistic pathogens should be considered in patients with newly diagnosed HD disease and atypical patterns of l ung involvement.