Corticosteroids for blastomycosis-induced ARDS: A report of two patients and review of the literature

Tim Lahm, Sheila Neese, Aaron T. Thomburg, Michael D. Ober, George A. Sarosi, Chadi Hage

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

ARDS secondary to blastomycosis is associated with a high mortality rate despite appropriate antifungal therapy. Corticosteroids are of proven benefit in the treatment of severe Pneumocystis jiroveci pneumonia and are recommended for the treatment of severe pulmonary infections with Histoplasma capsulatum. However, their role in the treatment of severe pulmonary infections with Blastomyces dermatitidis has not been established. We report the cases of two previously healthy men who presented with severe ARDS secondary to blastomycosis. Refractory hypoxemia developed in both patients despite adequate antifungal coverage with amphotericin B. Dramatic improvement was seen in each patient after initiation of corticosteroids in addition to amphotericin B. Both patients survived and did well on follow-up. We suggest that treatment with corticosteroids may be of benefit in patients with blastomycosis-induced ARDS. This may be due to a decrease in the severity of the inflammatory response.

Original languageEnglish
Pages (from-to)1478-1480
Number of pages3
JournalChest
Volume133
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Blastomycosis
Adrenal Cortex Hormones
Amphotericin B
Blastomyces
Histoplasma
Therapeutics
Pneumocystis carinii
Lung
Pneumocystis Pneumonia
Infection
Mortality

Keywords

  • Acute lung injury
  • Blastomyces dermatitidis
  • Histoplasma capsulatum
  • Methylprednisolone
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Corticosteroids for blastomycosis-induced ARDS : A report of two patients and review of the literature. / Lahm, Tim; Neese, Sheila; Thomburg, Aaron T.; Ober, Michael D.; Sarosi, George A.; Hage, Chadi.

In: Chest, Vol. 133, No. 6, 06.2008, p. 1478-1480.

Research output: Contribution to journalArticle

Lahm, Tim ; Neese, Sheila ; Thomburg, Aaron T. ; Ober, Michael D. ; Sarosi, George A. ; Hage, Chadi. / Corticosteroids for blastomycosis-induced ARDS : A report of two patients and review of the literature. In: Chest. 2008 ; Vol. 133, No. 6. pp. 1478-1480.
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