Blastomycosis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Blastomycosis
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

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

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

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

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

• Fever
• Cough
• Night sweats
• Muscle aches
• Joint pain
• Chest pain

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

Diagnosis

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
• Histopathology showing broad-based budding yeast
• Antigen detection in urine or serum

Treatment

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.
• Amphotericin B is used for severe or disseminated cases.

Prognosis

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

Prevention

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

Epidemiology

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

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  Blastomycosis lung infiltration
• 
  Blastomycosis illustration from 1905
• 
  Blastomyces dermatitidis GMS stain
• 
  Map of Blastomycosis distribution
• 
  Thomas Caspar Gilchrist
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  Dog with Blastomycosis
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  North American blastomycosis 1
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  North American blastomycosis 2
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  North American blastomycosis 3
• 
  Blastomycosis of skin

See Also

• Fungal infections
• Dimorphic fungi
• Pulmonary infections

External Links

• [CDC - Blastomycosis](https://www.cdc.gov/fungal/diseases/blastomycosis/index.html)
• [Infectious Disease Society of America - Blastomycosis Guidelines](https://www.idsociety.org/)