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'''Blastomycosis''' is a fungal infection caused by inhaling ''[[Blastomyces dermatitidis]]'' spores.
{{SI}}
[[File:North American blastomycosis (5279534581).jpg|alt=North American blastomyclosis|thumb|North American blastomyclosis]]
{{Infobox medical condition
== Definition ==
| name            = Blastomycosis
 
| image          = [[File:Blastomycosis_lung_infiltration.png|left|thumb|Lung infiltration in blastomycosis]]
<youtube>
| caption        = Chest X-ray showing lung infiltration in a patient with blastomycosis
title='''{{PAGENAME}}'''
| field          = [[Infectious disease]]
movie_url=http://www.youtube.com/v/t0VbR4duaOo
| symptoms        = [[Fever]], [[cough]], [[night sweats]], [[muscle pain]], [[joint pain]], [[chest pain]], [[fatigue (medical)|fatigue]]
&rel=1
| complications  = [[Acute respiratory distress syndrome]], [[chronic pulmonary disease]], [[disseminated disease]]
embed_source_url=http://www.youtube.com/v/t0VbR4duaOo
| onset          = Gradual
&rel=1
| duration        = Weeks to months
wrap = yes
| causes          = [[Blastomyces dermatitidis]]
width=750
| risks          = [[Immunocompromised]] individuals, [[outdoor activities]] in endemic areas
height=600
| diagnosis      = [[Microscopy]], [[culture (biology)|culture]], [[antigen detection]], [[serology]]
</youtube>
| differential    = [[Histoplasmosis]], [[coccidioidomycosis]], [[tuberculosis]], [[lung cancer]]
 
| prevention      = Avoidance of endemic areas, use of protective equipment
Blastocystis is a common microscopic organism that inhabits the intestine and is found throughout the world.  
| treatment      = [[Antifungal]] medications such as [[itraconazole]], [[amphotericin B]]
A full understanding of the biology of Blastocystis and its relationship to other organisms is not clear, but is an active area of research. Infection with Blastocystis is called blastocystosis.
| prognosis      = Generally good with treatment, but can be severe in immunocompromised individuals
 
| frequency      = Rare
== Signs and symptoms ==
}}
Watery or loose stools, diarrhea, abdominal pain, anal itching, weight loss, constipation, and excess gas have all been reported in persons with Blastocystis infection. Many people have no symptoms at all. The organism can be found in both well and sick persons.
Blastomycosis
 
{{Infobox disease
Blastocystis can remain in the intestine for weeks, months, or years.
| name          = Blastomycosis
[[File:Blasto-map 600.jpg|alt= Distribution of blastomycosis in North America |thumb|Distribution of blastomycosis in North America ]]
| image          = Blastomyces dermatitidis.jpg
== Cause ==
| caption        = Microscopic image of ''Blastomyces dermatitidis''
The role of Blastocystis in causing disease is controversial among experts. Some types of Blastocystis may be more likely to be associated with symptoms. Finding Blastocystis in stool samples should be followed up with a careful search for other possible causes of your symptoms.
| field          = Infectious disease
 
| symptoms       = Fever, cough, night sweats, muscle aches, joint pain, chest pain
== Incidence ==
| complications  = Chronic pulmonary infection, disseminated disease
Many people have Blastocystis in their intestine, some without ever having symptoms.
| onset          = 3-15 weeks after exposure
 
| duration      = Weeks to months
== Transmission ==
| causes        = ''Blastomyces dermatitidis''
How Blastocystis is transmitted is not known for certain, although the number of people infected seems to increase in areas where sanitation and personal hygiene is not adequate. Studies have suggested that risk of infection may increase through:
| risks          = Immunocompromised individuals, outdoor activities in endemic areas
[[File:An introduction to dermatology (1905) blastomycosis.jpg|alt=Blastomycosis|thumb|'''Blastomycosis''']]
| diagnosis      = Culture, histopathology, antigen detection
* ingesting contaminated food or water,
| treatment      = Antifungal medications (e.g., itraconazole, amphotericin B)
* exposure to a day care environment, or
| prognosis      = Good with treatment
* exposure to animals.
| frequency      = Rare
* How can I prevent infection with Blastocystis?
}}
* Wash your hands with soap and warm water after using the toilet, changing diapers, and before handling food.
== Introduction ==
* Teach children the importance of washing hands to prevent infection.
'''Blastomycosis''' is a [[fungal infection]] caused by the [[dimorphic fungus]] ''[[Blastomyces dermatitidis]]''. It primarily affects the [[lungs]] but can disseminate to other parts of the body, including the [[skin]], [[bones]], and [[central nervous system]]. The disease is endemic in certain regions of [[North America]], particularly in the [[Ohio]] and [[Mississippi River]] valleys, the [[Great Lakes]] region, and parts of [[Canada]].
* Avoid water or food that may be contaminated.
==Etiology==
* Wash and peel all raw vegetables and fruits before eating.
The causative agent of blastomycosis is ''Blastomyces dermatitidis'', a fungus that exists in two forms: a mold form in the environment and a yeast form in the human body. The fungus is found in moist soil and decaying organic matter, such as wood and leaves.
* When traveling in countries where the water supply may be unsafe, avoid drinking unboiled tap water and avoid uncooked foods washed with unboiled tap water.
==Pathophysiology==
* Bottled or canned carbonated beverages, seltzers, pasteurized fruit drinks, and steaming hot coffee and tea are safe to drink.
Inhalation of the [[conidia]] (spores) of ''Blastomyces dermatitidis'' leads to infection. Once inhaled, the spores transform into yeast forms in the [[alveoli]] of the lungs. The yeast can evade the [[immune system]] and multiply, leading to pulmonary infection. In some cases, the infection can spread hematogenously to other organs.
 
==Clinical Manifestations==
== Treatment ==
The clinical presentation of blastomycosis can vary widely. Common symptoms include:
The clinical significance of Blastocystis spp. is controversial.
* [[Fever]]
 
* [[Cough]]
Treatment with metronidazole^ at various doses has been reported, for example (adults):
* [[Night sweats]]
 
* [[Muscle aches]]
250 mg to 750 mg metronidazole^ orally 3 times daily for 10 days
* [[Joint pain]]
1500 mg metronidazole^ orally once daily for 10 days
* [[Chest pain]]
Note: Lack of response to metronidazole has been noted in some areas (Yakoob et al., Br J Biomed Sci 2004;61:75).
In cases of disseminated disease, patients may present with skin lesions, [[osteomyelitis]], or [[meningitis]].
[[File:Blastomycosis of skin.tif|alt=Blastomycosis of skin|thumb|Blastomycosis of skin]]
==Diagnosis==
Treatment with trimethoprim (TMP)^/sulfamethoxazole (SMX)^ at various doses has been reported, for example (adults):
Diagnosis of blastomycosis is based on clinical suspicion, especially in patients with a history of exposure in endemic areas. Diagnostic methods include:
 
* [[Culture]] of the organism from clinical specimens
6 mg/kg TMP^, 30 mg/kg SMX^ once daily for 7 days
* [[Histopathology]] showing broad-based budding yeast
320mg TMP^, 1600 mg SMX^ once daily for 7 days
* [[Antigen detection]] in urine or serum
160 mg TMP^, 800 mg SMX^ twice daily for 7 days
==Treatment==
Treatment with nitazoxanide^ has been shown to be effective in clearing organisms and improving symptoms at the following doses:
The primary treatment for blastomycosis is antifungal therapy. The choice of medication depends on the severity of the disease:
 
* [[Itraconazole]] is the drug of choice for mild to moderate disease.
Adults, 500 mg nitazoxanide^ orally twice daily for 3 days.
* [[Amphotericin B]] is used for severe or disseminated cases.
Children, 200 mg nitazoxanide^ orally twice daily for 3 days in patients aged 4–11 years, and 100 mg nitazoxanide^ orally twice daily for 3 days in patients aged 1–3 years.
==Prognosis==
Tinidazole^, paromomycin^, iodoquinol^, and ketoconazole^ have also been used for clearing Blastocystis, as presented in case reports or small series (see references).
With appropriate treatment, the prognosis for blastomycosis is generally good. However, untreated or severe cases can lead to significant morbidity and mortality.
 
==Prevention==
^Not FDA-approved for this indication.
Preventive measures include avoiding activities that disturb soil in endemic areas, especially for immunocompromised individuals. There is currently no vaccine available for blastomycosis.
 
==Epidemiology==
<!-- Prevention and treatment -->
Blastomycosis is considered a rare disease, with most cases occurring in North America. The incidence is higher in males and in individuals with occupational or recreational exposure to wooded or moist environments.
''Blastomyces dermatitis'' is found in the soil and decaying organic matter like wood or leaves
== Blastomycosis gallery ==
 
<!-- Epidemiology and history -->
Blastomycosis is [[Endemic (epidemiology)|endemic]] to the eastern United States, especially the Ohio and Mississippi River valleys, the Great Lakes, and the St. Lawrence River.  It is also endemic to some parts of Canada, including Quebec, Ontario, and Manitoba.
 
== Prognosis ==
Mortality rate in treated cases
 
* 0-2% in treated cases among immunocompetent patients
* 29% in immunocompromised patients
* 40% in the subgroup of patients with AIDS
* 68% in patients presenting as [[acute respiratory distress syndrome]] ([[ARDS]])
 
== Epidemiology ==
[[Image:Blasto-map 600.jpg|thumb|Distribution of blastomycosis in North America based on the map given by Kwon-Chung and Bennett,<ref name=kwonchung1992/> with modifications made according to case reports from a series of additional sources.
 
===Urban infections===
There is also a developing profile of urban and other domestic blastomycosis cases, beginning with an outbreak tentatively attributed to construction dust in [[Westmont, Illinois]].
 
<gallery>
<gallery>
File:North American blastomycosis 1.jpg|Granuloma with early suppuration. Fungal organisms difficult to recognize at this low magnification.
File:Blastomycosis lung infiltration.png|Blastomycosis lung infiltration
File:North American blastomycosis 2.jpg|Large yeast-like fungi seen within giant cells at arrows.
File:An introduction to dermatology (1905) blastomycosis.jpg|Blastomycosis illustration from 1905
File:North American blastomycosis 3.jpg|Large yeast-like fungi seen within giant cells at arrows.Budding yeasts in cytoplasm of giant cells at arrows. Broad-based budding and double countoured cell wall seen in the giant cell in the center is characteristic of Blastomyces dermatitidis.
File:Blastomyces dermatitidis GMS.jpeg|Blastomyces dermatitidis GMS stain
File:Blasto-map 600.jpg|Map of Blastomycosis distribution
File:Thomas Caspar Gilchrist.jpg|Thomas Caspar Gilchrist
File:Jeannie dog? (82610113).jpg|Dog with Blastomycosis
File:North American blastomycosis 1.jpg|North American blastomycosis 1
File:North American blastomycosis 2.jpg|North American blastomycosis 2
File:North American blastomycosis 3.jpg|North American blastomycosis 3
File:Blastomycosis of skin.jpg|Blastomycosis of skin
</gallery>
</gallery>
 
==See Also==
===Seasonal trends===
* [[Fungal infections]]
Seasonality and weather also appear to be linked to contraction of blastomycosis. Many studies have suggested an association between blastomycosis contraction and cool to moderately warm, moist periods of the spring and autumn.
* [[Dimorphic fungi]]
 
* [[Pulmonary infections]]
===Gender bias===
==External Links==
Sex is another factor inconstantly linked to contraction of blastomycosis: though many studies show more men than women affected.
* [CDC - Blastomycosis](https://www.cdc.gov/fungal/diseases/blastomycosis/index.html)
 
* [Infectious Disease Society of America - Blastomycosis Guidelines](https://www.idsociety.org/)
===Ethnic populations===
{{Infectious diseases}}
Ethnic group or race is frequently investigated in epidemiological studies of blastomycosis, but is potentially profoundly conflicted by differences in residence and in quality and accessibility of medical care, factors that have not been stringently controlled for to date.  
[[Category:Fungal diseases]]
 
[[Category:Pulmonary diseases]]
===Communicability===
[[Category:Infectious diseases]]
There are a very small number of cases of human-to-human transmission of ''B. dermatitidis'' related to dermal contact.
[[Category:Rare diseases]]
 
==Other animals==
Blastomycosis also affects an indefinitely broad range of mammalian hosts, and dogs in particular are a highly vulnerable sentinel species.
 
== See also ==
* [[Histoplasmosis]]
* [[Paracoccidioidomycosis]]
 
{{Mycoses|state=collapsed}}
 
[[Category:Animal fungal diseases]]
[[Category:Mycosis-related cutaneous conditions]]

Latest revision as of 18:36, 4 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Blastomycosis
Error creating thumbnail:
Lung infiltration in blastomycosis
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Fever, cough, night sweats, muscle pain, joint pain, chest pain, fatigue
Complications Acute respiratory distress syndrome, chronic pulmonary disease, disseminated disease
Onset Gradual
Duration Weeks to months
Types N/A
Causes Blastomyces dermatitidis
Risks Immunocompromised individuals, outdoor activities in endemic areas
Diagnosis Microscopy, culture, antigen detection, serology
Differential diagnosis Histoplasmosis, coccidioidomycosis, tuberculosis, lung cancer
Prevention Avoidance of endemic areas, use of protective equipment
Treatment Antifungal medications such as itraconazole, amphotericin B
Medication N/A
Prognosis Generally good with treatment, but can be severe in immunocompromised individuals
Frequency Rare
Deaths N/A


Blastomycosis

Blastomycosis
Microscopic image of Blastomyces dermatitidis
ICD-10
ICD-9
DiseasesDB
MedlinePlus
eMedicine
MeSH ID

Introduction[edit]

Blastomycosis is a fungal infection caused by the dimorphic fungus Blastomyces dermatitidis. It primarily affects the lungs but can disseminate to other parts of the body, including the skin, bones, and central nervous system. The disease is endemic in certain regions of North America, particularly in the Ohio and Mississippi River valleys, the Great Lakes region, and parts of Canada.

Etiology[edit]

The causative agent of blastomycosis is Blastomyces dermatitidis, a fungus that exists in two forms: a mold form in the environment and a yeast form in the human body. The fungus is found in moist soil and decaying organic matter, such as wood and leaves.

Pathophysiology[edit]

Inhalation of the conidia (spores) of Blastomyces dermatitidis leads to infection. Once inhaled, the spores transform into yeast forms in the alveoli of the lungs. The yeast can evade the immune system and multiply, leading to pulmonary infection. In some cases, the infection can spread hematogenously to other organs.

Clinical Manifestations[edit]

The clinical presentation of blastomycosis can vary widely. Common symptoms include:

In cases of disseminated disease, patients may present with skin lesions, osteomyelitis, or meningitis.

Diagnosis[edit]

Diagnosis of blastomycosis is based on clinical suspicion, especially in patients with a history of exposure in endemic areas. Diagnostic methods include:

Treatment[edit]

The primary treatment for blastomycosis is antifungal therapy. The choice of medication depends on the severity of the disease:

Prognosis[edit]

With appropriate treatment, the prognosis for blastomycosis is generally good. However, untreated or severe cases can lead to significant morbidity and mortality.

Prevention[edit]

Preventive measures include avoiding activities that disturb soil in endemic areas, especially for immunocompromised individuals. There is currently no vaccine available for blastomycosis.

Epidemiology[edit]

Blastomycosis is considered a rare disease, with most cases occurring in North America. The incidence is higher in males and in individuals with occupational or recreational exposure to wooded or moist environments.

Blastomycosis gallery[edit]

See Also[edit]

External Links[edit]



Infectious diseases
Bacterial
Viral
Fungal
Parasitic
Prion
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