Cervical manifestation of blastomycosis

Blastomycosis is a common systemic fungal infection in which the physical a nd radiographic findings appear far more serious than the subjective signs and symptoms. Although blastomycosis of the head and neck is often difficul t to diagnose, clues in the patient's history and a few laboratory tests ca n establish the diagnosis. Involvement of the skin and soft tissues provide s an unusual opportunity for direct access to the organism for culture and pathologic diagnosis. We present a case of blastomycosis presenting in a si ngle abscessed cervical lymph node. The diagnosis was established by fine-n eedle aspiration of the cervical mass. The primary lung disease was confirm ed by chest radiography and computed tomography. The clinical and pathologi c features of the disease are discussed.