Abstract：
BACKGROUND: In presenting this case of tick-borne illness in a patient with known disseminated blastomycosis, we aim to discuss the clinical reasoning and decision-making process when treating a septic presentation in a complex patient with multiple exposures and risk factors, from identifying and addressing the most devastating differentials to selecting appropriate empiric anti-infective regimens.
METHODS: We present the case of a 60-year-old male with a medical history of diastolic heart failure, cirrhosis, sarcoidosis, hypertension, splenectomy, and recently diagnosed disseminated blastomycosis, who developed sepsis following a recent tick exposure.
CONCLUSIONS: While a review of the literature revealed a paucity of cases of coexisting fungal and tick-borne illness, each is independently well-studied. Several reported commonalities exist between Blastomyces and Anaplasma, including endemic regions and at-risk populations.
METHODS: We present the case of a 60-year-old male with a medical history of diastolic heart failure, cirrhosis, sarcoidosis, hypertension, splenectomy, and recently diagnosed disseminated blastomycosis, who developed sepsis following a recent tick exposure.
CONCLUSIONS: While a review of the literature revealed a paucity of cases of coexisting fungal and tick-borne illness, each is independently well-studied. Several reported commonalities exist between Blastomyces and Anaplasma, including endemic regions and at-risk populations.
摘要：
背景：在一例已知播散性芽生菌病的患者中，我们的目的是讨论临床推理和决策过程，当治疗脓毒症表现在一个复杂的病人有多个暴露和危险因素，从识别和解决最具破坏性的差异到选择适当的经验性抗感染方案。
方法：我们介绍了一个有舒张性心力衰竭病史的60岁男性，肝硬化,结节病,高血压,脾切除术,最近被诊断为播散性芽生菌病，在最近的蜱暴露后出现了败血症。
结论：虽然文献综述显示，真菌和蜱传疾病并存的病例很少，每个都是独立研究的。据报道，芽胞杆菌属和无性体之间存在一些共性，包括流行地区和高危人群。
方法：我们介绍了一个有舒张性心力衰竭病史的60岁男性，肝硬化,结节病,高血压,脾切除术,最近被诊断为播散性芽生菌病，在最近的蜱暴露后出现了败血症。
结论：虽然文献综述显示，真菌和蜱传疾病并存的病例很少，每个都是独立研究的。据报道，芽胞杆菌属和无性体之间存在一些共性，包括流行地区和高危人群。
