ArticleMedicine2016
Management and Outcomes of Acute Respiratory Distress Syndrome Caused by Blastomycosis: A Retrospective Case Series.
Article in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 36 citations in OpenAlex.
- Hypoxemic Respiratory Failure and Coccidioidomycosis-Associated Acute Respiratory Distress Syndrome.Open forum infectious diseases · 2024Trial
- Role of Blastomyces BAD-1 IgG Enzyme Immunoassay (EIA) for the diagnosis of blastomycosis in persons residing in an endemic area.Medical mycology · 2026Article
- Endemic Mycoses for Pulmonary Clinicians: From Nodules to ARDS.CHEST pulmonary · 2025Review
- Siblings in the ICU: Keeping Endemic Mycoses on the Differential.Case reports in pediatrics · 2025Article
- Battling the breath-stealers:Medical mycology case reports · 2024Article
- Article
- Diagnostic delay in pulmonary blastomycosis: a case series reflecting a referral center experience.Infection · 2023Article
- Blastomycosis: A Review of Mycological and Clinical Aspects.Journal of fungi (Basel, Switzerland) · 2023Review
- Fatal acute respiratory distress syndrome caused by blastomycosis after recent orthotopic liver transplantation in a non-endemic area.Medical mycology case reports · 2022Article
- Article
- Article
- Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology.The Lancet. Infectious diseases · 2021Review
- Clinical Manifestations and Outcomes in Immunocompetent and Immunocompromised Patients With Blastomycosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Could natural products modulate early inflammatory responses, preventing acute respiratory distress syndrome in COVID-19-confirmed patients?Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2021Review
- Clinical Manifestations and Treatment of Blastomycosis.Clinics in chest medicine · 2017Review
- Fatal Pulmonary Failure-A Rare Case of Blastomycosis Induced Acute Respiratory Distress Syndrome: A Case Report and Literature Review.Journal of investigative medicine high impact case reportsReview
- Outcomes of patients with blastomycosis-associated respiratory failure requiring veno-venous ECMO: a case series.Therapeutic advances in respiratory diseaseArticle
- Beware of the Acute Respiratory Distress Syndrome in a Pulmonary Blastomycosis!Journal of investigative medicine high impact case reportsArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute respiratory distress syndrome (ARDS) is an uncommon, highly fatal, and poorly understood manifestation of blastomycosis. Optimal management remains unknown, including the roles of adjunctive corticosteroids and extracorporeal membrane oxygenation (ECMO).We conducted a retrospective chart review of patients with ARDS caused by blastomycosis, managed in intensive care units in Manitoba, Canada, from 1992 to 2014. ARDS was defined using the Berlin definition. Corticosteroid therapy was defined as ≥150 mg cortisol equivalent in 24 hours. Logistic regression was used to identify determinants of a fatal outcome, and bootstrap resampling was used to assess sample size requirements.Forty-three patients with ARDS caused by blastomycosis were identified. ARDS was mild, moderate, and severe in 2 (5%), 12 (28%), and 29 (67%) patients, respectively. Management included amphotericin B (n = 42, 98%), vasopressors (n = 36, 84%), corticosteroids (n = 22, 51%), renal replacement (n = 13, 30%), and ECMO (n = 4, 11%). Seventeen patients (40%) died. All patients treated with ECMO survived (P = 0.14). Corticosteroids were not associated with survival benefit in univariate (P = 0.43) or multivariate analyses (odds ratio 0.52, 95% confidence interval 0.11-2.34). Bootstrap studies indicated that almost 500 patients would be needed to confirm a significant reduction in mortality from corticosteroids (type I error = 0.05, power = 80%).Blastomycosis is an uncommon, albeit important, cause of ARDS in this geographic area. Given the rarity of disease and the large cohort needed to demonstrate mortality benefit, the role of adjunctive therapies, including corticosteroids and ECMO, may remain unconfirmed, and clinical judgment should guide management decisions.
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Registered trials
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