The cytological diagnosis of pulmonary blastomycosis
M. L. Trumbull and T. M. Chesney
We reviewed 30 episodes of pulmonary blastomycosis among 29 patients to
compare the methods of diagnosis and to assess the usefulness of
cytological sputum examination. Complement fixation and skin tests were not
helpful in diagnosis. Confirmation by culture of sputum or tissue required,
on average, five weeks. We compared the cytological examination of
bronchial secretions with that of microbiologic wet smears. The cytological
technique yielded a positive diagnosis in 93% of patients and in 70% on the
first specimen. Sixty-one percent of microbiologic wet smears proved
positive, with 32% positive on the first specimen. The cytological findings
were reported significantly sooner. In addition, cytological diagnosis of
Blastomyces dermatitidis in sputum and bronchial washings of patients
suspected of having a pulmonary cancer or infection reduced the time of
diagnostic workup and the incidence of major surgery.
