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Blastomycosis
Aka: Blastomycosis, Blastomyces dermatidis
- See Also
- Cutaneous Blastomycosis
- Fungal Lung Infection
- Etiology
- Blastomyces dermatidis
- Pathophysiology
- Transmitted by exposure to contaminated soil or decomposing timber
- Inhalation of spores
- Traumatized, non-intact skin exposure (see Cutaneous Blastomycosis)
- Endemic regions of United States
- Ohio River Basin
- Mississippi River Basin
- Great Lakes
- St. Lawrence River
- Symptoms
- Pulmonary involvement is initially asymptomatic in 50% of cases
- Fever
- Sweating
- Cough
- Nocturnal Joint Pain
- Signs
- Acute disease
- See Cutaneous Blastomycosis
- Self-limited Pneumonia may clear spontaneously in most patients
- Disseminated blastomyces lesions (severe cases may be fatal)
- Bone
- Nervous system
- Lungs
- Liver
- Spleen
- Kidney
- Imaging: Chest XRay of Chronic Blastomycosis
- Test Sensitivity: 66%
- Osteolytic lesions
- Lab
- Microscopy
- Broad-based budding
- Skin lesion Evaluation
- Pustular discharge for Potassium Hydroxide
- Skin biopsy
- See Cutaneous Blastomycosis
- Systemic disease
- Bone Marrow Aspirate
- Sputum
- Management
- Progressive, refractory, or severe disease or Central Nervous System involvement
- Amphotericin B 0.5-0.6 mg/kg daily (MAX 2.0 - 2.5g)
- Indolent disease
- Adults: Itraconazole 200 mg orally daily for 6 months
- Children and Pregnant women: Amphotericin B at dosing above
- Course
- Incubation: 30-45 days
- References
- Altman (2007) Am Fam Physician 76:1533-4 [PubMed]
- Bradsher (2003) Infect Dis Clin North Am 17:21-40 [PubMed]