Blastomycosis Summary Pathogen: • Dimorphic fungus - Blastomyces dermatitidis or Blastomyces gilchristii. • The fungus lives in moist soil and in decomposing matter such as wood and leaves Epidemiology: • Mississippi and Ohio River basins, midwestern states, Canadian provinces bordering the Great Lakes, small area in New York and Canada along the St. Lawrence River and the Nelson River Risk Factors: • Immunosuppression • Collagen vascular disease • Pregnancy • Outdoor worker (Farmer and forestry work, hunting, and camping) The Disease: • Pulmonary (91%): Acute / Chronic Pneumonia • Skin (18%): Second most common manifestation after pneumonia. Verrucous lesion, with irregular borders. Lesion may mimic squamous cell carcinoma • Bone (4%): Soft tissue swelling or a chronic draining sinus tract adjacent to the focus of osteomyelitis • Genitourinary (2%): Presents as prostatitis and epididymoorchitis • CNS (1%): Meningitis, epidural abscess, or intracranial abscesses, particularly in the cerebellum Diagnosis: 1) Fresh wet (KOH) preparations of sputum, pleural fluid, BAL, CSF, urine, Skin tissue 2) Culture 3) Ag serum/urine Treatment: • Mild-moderate • Moderate-severe • CNS By @TheIDtrivia #Blastomycosis #diagnosis #management #treatment #infectiousdiseases
