| name: | Blastomycosis |
| also known as: | North American Blastomycosis; Gilchrist's Disease; Blastomycosis Fungal Infection; Blastomycosis Fungus Infection; Fungal Lung Infection; Pulmonary Mycosis; ICD 116.0 |
| also see: | Cryptococcus; Histoplasmosis; Valley Fever; Aspergillosis; Mucormycosis; Systemic Candidiasis; Fungus Infection; ICD |
| description: | Blastomycosis is a fungal infection of the lungs, occasionally spreading throughout the body, especially to the skin, common in farmers and gardeners of Southeastern USA and the Mississippi valley and Ohio river valley. Risk is increased with diabetes and in people with immunodeficiency disease, such as on chemotherapy or AIDS. Incubation is 30-45 days. Usually occurs from inhalation of fungus spores, direct skin involvement, and rarely through sexual intercourse. Blastomycosis can be divided into following : 1, Acute ( acute pulmonary) - fever, chills, cough, hemoptysis, muscle aches and pains, erythema nodosum 2. Chronic (chronic pulmonary) - cough, hemoptysis, shortness of breath, pleurisy, pleural effusion, nodular and cavitary lung lesions 3. Skin - papule or ulcerative skin lesion, skin nodules, warty lesions 4. Bone - osteolytic bone lesion usually involving long bones, vertebra and ribs, arthritis of larger joints knees, ankles, hips 5. Genitourinary - urinary obstruction, prostate enlargement from prostate, testes, epididymis involvement 6. Other - can involve brain such as in people with AIDS, as well as involve liver, spleen, pericardium, thyroid, adrenal gland, intestinal tract |
| signs & symptoms: | A slowly progressive cough, chest pain, shortness of breath, fever, chills and sweating, coughing up blood, pleurisy, weight loss, as well as skin sores. See Description above for six sub-types. |
| diagnosis: | Based on signs, symptoms, plus laboratory analysis of skin sores, sputum from the lungs for culture and gram stain, chest x-ray showing non-caseating granulomas, blood serology, KOH prep of sputum sample, CT scan if suspect brain, bone involvement. Occasionally, biopsy of lesions if needed, including bronchoscopy, for histology and culture. Differential diagnosis includes: Lung - other fungal infection lungs, bacterial pneumonia, lung abscess, lung cancer, tuberculosis Skin - other fungal infections skin, skin cancer, impetigo Bone - benign bone tumor, malignant bone tumor, osteomyelitis, tuberculosis Genitourinary - prostatitis, prostate cancer, tuberculosis |
| treatment: | Treatment is primarily antifungal medicine prescribed by the doctor, such as oral itraconazole for non-life threatening disease. For more severe life threatening disease, hospitalization and IV amphotericin B, flucytosine or itraconazole. Abscess and deep lesions might require debridement and/or drainage. |
| prevention: | Other than avoiding areas where the fungus habitat is, there is no prevention. |
| outcome: | With aggressive treatment, blastomycosis is curable in 90 percent of cases, 10 percent will relapse. Failure to treat and resistant cases can present with severe illness and can be fatal. |
skynetMD suggests the following:
| if: | If the person has either a wet or a dry cough, chest pain, chills, fever, sweats, shortness of breath, weight loss, or severe headache and a stiff neck |
| go to: | Go to the doctor |
Last updated 6/27/2009