Blastomycosis Presenting With Acute Airway Obstruction From a Retropharyngeal Abscess and Complicated by Severe Hypokalemia During Posaconazole Therapy: A Case Report and Review of Literature

John J Hanna; Jessica M Guastadisegni; Marcus A Kouma; Emily B Knez; Reuben J Arasaratnam; Donald F Storey

doi:10.1093/ofid/ofac414

Blastomycosis Presenting With Acute Airway Obstruction From a Retropharyngeal Abscess and Complicated by Severe Hypokalemia During Posaconazole Therapy: A Case Report and Review of Literature

Open Forum Infect Dis. 2022 Aug 11;9(8):ofac414. doi: 10.1093/ofid/ofac414. eCollection 2022 Aug.

Authors

John J Hanna¹, Jessica M Guastadisegni², Marcus A Kouma², Emily B Knez², Reuben J Arasaratnam^{1

2}, Donald F Storey^{1

2}

Affiliations

¹ Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
² Medicine Service, Infectious Disease Section, Veterans Affairs North Texas Health Care System, Dallas, Texas, USA.

Abstract

We report a case of cervical blastomycosis with associated paravertebral involvement and severe spinal canal stenosis in a 48-year-old patient presenting with acute airway obstruction from a retropharyngeal abscess. Our case was also complicated by severe hypokalemia that developed during the blastomycosis treatment course with posaconazole and which improved after discontinuation and replacement therapy. After 12 months of blastomycosis-targeted therapy, our patient had complete resolution of clinical, laboratory, and radiological findings of blastomycosis.

Keywords: abscess; blastomycosis; hypokalemia; posaconazole; retropharyngeal.

Publication types

Case Reports