Fulminant blastomycosis with blastomycotic infection of a cerebral glioma: Light microscopic and ultrastructural observations

Except for isolated case reports, blastomycosis has not been identified as a significant problem in immunosuppressed patients. We describe an unusual case with blastomycotic infection of a cerebral glioma in a 56-year-old man who underwent radiotherapy for his tumor and died of fulminant blastomycotic pneumonia. This is believed to be the first reported case of Blastomyces dermatitidis infection of a cerebral glioma. The light microscopic and ultrastructural features of B. dermatitidis, the giant forms of which were encountered in our patient, are described, and the role of immuno-suppression due to steroid therapy in the pathogenesis of this fulminant infection are reviewed.