Blastomycosis
Background
- Fungus: Blastomyces dermatitidis
- Lives in moist soil, wooded areas
- Spores airborne
- Incubation: 3-6 weeks
- North, Central and South America
- Southeast and Midwest US (Mississippi and Ohio River valleys)
- Reportable disease
Clinical Features
- Flu like symptoms: Fever, chills, cough, muscle aches, joint pain, chest pain
- Pulmonary: most comont
- Skin:
- Bone
- Genitourinary:
- CNS
Differential Diagnosis
- Pneumonia
- Malignancy
- Tuberculosis
- Pyoderma gangrenosum
- Keratoacanthoma
Workup
- Fungal culture (Blood, sputum, bone marrow, liver or skin)
- Antigen test (Serum or urine)
- Serum antibodies
Management
- Mild or moderate infections: Itraconazole
- Severe infection: Voriconazole