Rare fungal infection often misdiagnosed
Published Sunday, November 27, 2011 10:24PM EST
Doctors are warning about a rare and serious, but treatable infection called blastomycosis that is being too often missed by doctors and hospitals alike, resulting in tragic consequences.
Blastomycosis is a disease caused by fungus that lives in moist soil in wooded areas in parts of central Canada and the U.S. If inhaled, the fungus can cause mild breathing problems that are often dismissed or misdiagnosed, until they worsen and cause serious illness.
Awrey Southey, 21, recently developed the infection. He had spent the summer in northern Ontario wilderness, building a log cabin. When he returned to university in London, Ont. in September, he started to feel sick.
"I felt really tired. I had fevers that wouldn't go away, so sleeping didn't last for very long," he says.
When Southey developed chest pains he went to London Health Sciences Centre. Doctors said he had pneumonia. After a short stay in hospital, they sent him home with antibiotics to clear up what they assumed was bacterial pneumonia.
But the treatments didn't work and Awrey was getting sicker. His worried parents, both doctors, took him to a hospital in Oakville.
"I was quite concerned about him," says his father George Southey. "Seeing him continue to waste away despite multiple antibiotics was quite frightening."
Awrey underwent a number of tests but doctors couldn't come up with a diagnosis.
Doctors tested Southey for blastomycosis, among a number of other infections, but the test came back negative, leaving Southey's family baffled.
"It was very much a mystery," says George. "There's nothing quite as frightening as uncertainty."
Finally, a doctor decided to do a more thorough sputum test for blastomycosis. This time, it was positive.
Weeks later, Southey is still recovering and catching up with what he missed in school.
Although blastomycosis is rare, it can also be deadly.
"The problem with this condition is the diagnosis has to be on your mind the whole time," says Dr. John Embil, an infectious disease expert and the director of infection prevention and control at Winnipeg's Health Sciences Centre. "Otherwise, if it doesn't come into your head, you likely won't think of the diagnosis."
In an interview with CTV News, Embril said the easy-to-miss infection can even go misdiagnosed as lung cancer. "The consequences of overlooking blastomycosis are that the condition can continue to gallop along, making the person who has it sicker and sicker."
Ted Woodard, a father of one from Chatham, Ont. died earlier this year after his blastomycosis infection wasn't detected until he was already in a coma.
Woodard had symptoms of the infection for months, including a cough and nasal congestion that developed into painful sores inside his mouth and nostrils. He described the pain as "having glass shards pressed into his nostrils."
Then, sores and abscesses began to develop along his feet, making it difficult to walk. Again, antibiotics were tried but failed to have any effect.
Woodard was admitted to hospital six months after his symptoms started and underwent a lung biopsy. That's when the blastomycosis diagnosis was made. He was quickly given infusions of antifungal medications but by then, the infection couldn't be stopped, says his sister Linda.
"We went from feeling elated that he would get better to utter despair that the disease had progressed to the point where it couldn't be turned around," she said.
Woodard died less than three weeks after his diagnosis.
According to Embril, more doctors need to think about this infection when they see otherwise healthy patients with lung problems that don't seem to be improving.
"The message to healthcare providers and patients alike is if the pneumonia is not getting better in a usual length of time, you need to think out of the box," he says.
"People could definitely die if this is missed. The pneumonias could be very significant and lead to respiratory failure and possibly even death."
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip