Nasopharyngeal and temporal bone blastomycosis: CT and MR findings.

Blastomycosis is a fungal disease endemic to the Mississippi and Ohio River valleys and to the southeastern United States [1 ]. From the time blastomycosis was first isolated from the skin by Gilchrist in 1896 [2] , numerous epidemiologic, laboratory, and clinical data have been collated in an attempt to fully define this disease process. There is wide variability in the clinical presentation, depending on the organ of involvement. Pulmonary, skin, and CNS involvement are well documented in the literature. However, a review of published reports revealed no previous cases of extensive nasopharyngeal and temporal bone involvement from disseminated disease. We present two case reports of patients with strikingly similar clinical and radiologic presentations.