Blastomycosis

Abstract

Blastomycosis is an uncommon but important systemic mycosis caused by the fungus Blastomyces dermatitidis. Endemic to most of the eastern United States and parts of Canada, primary infection usually occurs via inhalation of aerosolized infectious spores which may lead to acute pneumonitis. Rarely, acute infection results in rapidly progressive pneumonia and respiratory compromise. In its chronic form, pneumonia is the most common clinical presentation of blastomycosis and may mimic neoplasms or other granulomatous infectious clinically and radiographically. Extrapulmonary involvement of the skin, bone, and male genitourinary tract are common, usually occurring with concomitant pulmonary involvement. Itraconazole is the oral antifungal of choice for most cases of mild to moderate disease, while amphotericin B is generally given to patients with life-threatening and central nervous system involvement. Blastomycosis can be unusually severe in immunocompromised patients, and early diagnosis and aggressive intervention are essential for a good outcome.

Key Word:

blastomycosis