Carignan et al identified risk factors for severe blastomycosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Universite de Sherbrooke and Laboratoire de SantePublique du Quebec in Canada.
Patient selection: blastomycosis in Quebec, from 1988 to 2016
Outcome: 90-day mortality
Risk factors for severe blastomycosis:
(1) older age (aOR 1.04 per year; median age for fatal disease was 62 vs 54 survivors)
(2) immunosuppression (aOR 4.2)
(3) involvement in > 2 lung lobes (aOR 5.3)
where:
• Abstract has >= 2 lung lobe involvement while Table 2 shows > 2.
Other factors that may contribute:
(1) diabetes mellitus
(2) Charlson comorbidity index >= 3
(3) delay in diagnosis and start of appropriate therapy
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