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BlastomycosisAka: Blastomyces dermatidis

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

Blastomycosis (C0005716)

Definition (MSH)A fungal infection that may appear in two forms: 1, a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2, chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung.
Definition (CSP)infection caused by fungi of the genus Blastomyces.
ConceptsDisease or Syndrome (T047)
ICD9116, 116.0
MSHD001759
EnglishBlastomycoses, Blastomycosis, Blastomycotic infection, Chicago disease, Gilchrist's disease, Infection by Blastomyces, North American blastomycosis, Other dermatophytosis
Spanishblastomicosis, blastomicosis norteamericana, enfermedad de Chicago, enfermedad de Gilchrist, infeccion blastomicotica, infeccion por Blastomyces
Parent ConceptsMycoses (C0026946), Blastomycosis (C0005716), Dermatomycoses (C0011630), Infection by Deuteromycetes (C0276698), Duplicate concept (C1274013), Infection by Ascomycetes (C0276697), Ambiguous concept (C1274012)
SourcesCSP, ICD9CM, LCH, MSH, MTH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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