blastomycosis

What is Blastomycosis?

Blastomycosis is a rare fungal infection caused by inhaling spores of the fungi Blastomyces dermatitidis or Blastomyces gilchristii. This infection can affect humans and animals, with most cases reported in North America [1][2].

Causes and Transmission

The fungus that causes blastomycosis is found in decaying wood and soil. When the spores of this fungus are inhaled, they can cause an infection in the lungs [3]. This is usually how people get infected with blastomycosis.

Symptoms

The symptoms of blastomycosis can vary from person to person but may include:

• A productive or dry hacking cough
• Chest pain
• Dyspnea (difficulty breathing)
• Fever
• Chills
• Drenching sweats
• Pleural effusion (fluid accumulation in the space surrounding the lungs) occasionally [4].

Some people may also experience more severe symptoms such as night sweats, anorexia, weight loss, and malaise [5].

Disease Characteristics

Blastomycosis is a systemic pyogranulomatous infection that can affect various parts of the body. It is one of the great mimickers in medicine, meaning it can resemble other diseases or conditions [6]. The disease can cause verrucous cutaneous blastomycosis (a skin condition) and mass-like lung opacities due to the fungus [7].

Other Facts

Blastomycosis is also known as Gilchrist's disease. It is a pulmonary disease usually caused by the dimorphic fungus Blastomyces dermatitidis [8]. The infection can be treated with antifungal medications, but it requires prompt medical attention to prevent complications.

References:

[1] May 9, 2024 — Blastomycosis — also known as Gilchrist's disease — is a pulmonary disease usually caused by the dimorphic fungus Blastomyces dermatitidis. [8]

[2] Nov 15, 2022 — Blastomycosis is a rare fungal infection that can affect humans and animals. Infection usually occurs by breathing in spores of the fungi... [5]

[3] Oct 26, 2022 — Blastomycosis is a rare fungal infection usually acquired by breathing in the spores of the fungi Blastomyces dermatitidis or Blastomyces gilchristii. [2]

[4] Symptoms include a productive or dry hacking cough, chest pain, dyspnea, fever, chills, and drenching sweats. Pleural effusion occurs occasionally. Some... [3]

[5] by JA McBride · 2017 · Cited by 195 — Symptoms can include fever, persistent cough, hemoptysis, night sweats, anorexia, weight loss and malaise. Chest radiography can show nodules, masses or... [4]

[6] by M Saccente · 2010 · Cited by 449 — Blastomycosis is one of the great mimickers in medicine; verrucous cutaneous blastomycosis resembles malignancy, and mass-like lung opacities due to B. [6]

[7] Jan 9, 2019 — Blastomycosis is a systemic pyogranulomatous infection usually caused by the inhalation of (spores) conidia of Blastomyces dermatitidis. [6]

[8] Result: noun | any of several infections of the skin or mucous membrane caused by Blastomyces [10]

Symptoms of Blastomycosis

Blastomycosis, an infection caused by the fungus Blastomyces, can manifest in various ways, affecting different parts of the body. The symptoms can range from mild to severe and may include:

• Respiratory Symptoms: Cough, chest pain, fever, chills, difficulty breathing (dyspnea), and a productive or dry hacking cough [3][4][13]
• Musculoskeletal Symptoms: Joint pain, muscle aches, fatigue, and general discomfort [8][10]
• Skin and Soft Tissue Infections: Skin sores, ulcers, bumps, blisters, and bleeding easily [4][11]
• Systemic Symptoms: Fever, chills, night sweats, and general feeling of illness or unease [8][11]

It's essential to note that about 50% of people infected with Blastomyces may not develop any symptoms or may experience mild symptoms that resolve without treatment. However, in some cases, the infection can progress to more severe forms, such as acute respiratory distress syndrome and death [5][15].

If you suspect you have blastomycosis or are experiencing symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

[1] Signs and symptoms in animals. Pets, particularly dogs, can get blastomycosis, but spread between animals and people is very rare. [2] The signs and symptoms of illness that can result from exposure to this soil organism are variable. [3] Blastomycosis is an infection caused by the fungus Blastomyces. Infections are caused by breathing in fungal spores. [4] Symptoms · May look like warts or ulcers · Are usually painless · Vary in color from gray to violet · May appear in the nose and mouth · Bleed easily and form ... [5] The clinical manifestations of blastomycosis are broad, ranging from asymptomatic infection to acute respiratory distress syndrome and death. [6] People have a fever, chills, and drenching sweats and sometimes chest pain, difficulty breathing, and a cough. · The infection may spread to the skin, bones, ... [7] Apr 8, 2009 — The symptoms vary greatly according the affected organ system. It is characterized by cough, chest pain, fever, chills, and shortness of breath. [8] Symptoms of blastomycosis include: Fever. Chills. Fatigue. Cough. Shortness of breath (dyspnea). Muscle aches. Coughing up blood. Night sweats. Skin sores, ulcers, bumps or blisters. [9] Blastomyces dermatitidis is a type of ... [10] Symptoms of blastomycosis include: Fever. Chills. Fatigue. Cough. Shortness of breath (dyspnea). Muscle aches. Coughing up blood. Night sweats. Skin sores, ulcers, bumps or blisters. [11] Symptoms of blastomycosis include: Fever. Chills. Fatigue. Cough. Shortness of breath (dyspnea). Muscle aches. Coughing up blood. Night sweats. Skin sores, ulcers, bumps or blisters. [12] Blastomycosis is a lung infection caused by a fungus that lives in soil in parts of the U.S. Skip directly to site content Skip directly to search. ... Symptoms of Blastomycosis. Blastomycosis usually affects the lungs and causes symptoms of pneumonia. [13] Symptoms and Signs of Blastomycosis. Pulmonary blastomycosis. Pulmonary blastomycosis may be asymptomatic or cause an acute, self-limited disease that often goes unrecognized. It can also begin insidiously and develop into a chronic, progressive infection. Symptoms include a productive or dry hacking cough, chest pain, dyspnea, fever, chills ... [14] Acute pulmonary blastomycosis is the most common type of blastomycosis. 2 It can present as asymptomatic; a mild, self-limited disease; or an insidious infection that can progress to acute respiratory distress syndrome and death. 1,2 . Symptoms of pulmonary blastomycosis are nonspecific and may include the following 2: Cough; Chest pain; Fever; and [15] The signs and symptoms of blastomycosis vary among individuals. About 50% of infections are asymptomatic (person does not develop any symptoms or disease) or are mild and resolve without treatment. Some patients develop a chronic lung infection or the disease can spread to other areas of the body (skin, bones, central nervous system, or ...

Diagnostic Tests for Blastomycosis

Blastomycosis, a fungal infection caused by Blastomyces dermatitidis, can be diagnosed through various tests. Here are some of the diagnostic methods used to detect this condition:

• Direct Identification: The fastest way to diagnose blastomycosis is by direct identification of the broad-based budding yeast forms under microscopy [2]. This method involves examining specimens such as sputum, urine, or tissue samples for the presence of fungal cells.
• Enzyme Immunoassay (EIA): An enzyme immunoassay (EIA) urine antigen test can be used to detect blastomycosis. EIA is a sensitive and specific test that can aid in the diagnosis of this condition [1].
• MVista® Blastomyces Antigen Quantitative EIA: This test can detect and quantify the amount of Blastomyces antigen in patient samples, making it useful for diagnosing blastomycosis [3].
• Chest X-ray and Clinical Diagnosis: In some cases, diagnosis may be made based on clinical symptoms and a chest x-ray. However, laboratory identification of the fungi is necessary to confirm the diagnosis [4].

Other Diagnostic Tests

In addition to these methods, other tests such as:

• Culture and Cytopathology: These remain the gold standard for diagnosing blastomycosis, although they may take longer than antigen testing [5].
• Blastomyces Antibody Immunodiffusion Test: This test is used to determine precipitating antibodies to Blastomyces dermatitidis, but it is not as commonly used as other methods [6].

Most Accurate Diagnostic Test

The MVista® Blastomyces Antigen Quantitative EIA is considered the single most accurate diagnostic test for blastomycosis, especially in certain clinical scenarios [7].

Treatment Options for Blastomycosis

Blastomycosis, a fungal infection caused by Blastomyces dermatitidis, requires prompt and effective treatment to prevent complications and ensure patient recovery. The primary goal of treatment is to eliminate the fungus from the body.

Initial Therapy

For patients with severe illness or rapidly progressive infections, including those affecting the central nervous system (CNS), Amphotericin B is typically the initial drug of choice [6]. This antifungal medication is administered intravenously and helps to quickly reduce fungal load in the body.

Step-Down Therapy

Once the patient's condition stabilizes, a step-down therapy approach may be employed. In this scenario, Itraconazole is often used as a preferred agent [2]. This oral antifungal medication is more readily absorbed than other options and has enhanced antimycotic properties [7].

Alternative Treatment Options

For patients with mild to moderate cases of blastomycosis, Itraconazole is typically recommended as the first-line treatment option [5, 8]. In some cases, Voriconazole may be used as an alternative antifungal agent.

Additional Considerations

• Fluconazole, another oral antifungal medication, may also be considered for treatment in certain situations.
• The choice of antifungal therapy should be individualized based on the patient's specific needs and medical history.

References:

1. Jan 9, 2019 — Antifungal Treatment. Amphotericin B and itraconazole continue to be the main drugs used in the treatment of blastomycosis.
2. by RW Bradsher Jr · Cited by 4 — - Initial therapy with amphotericin B · - Step-down therapy · Voriconazole as preferred agent · Alternatives to voriconazole.
3. by JA McBride · 2017 · Cited by 195 — Itraconazole is the first-line agent for the treatment of mild to moderate, non-CNS blastomycosis, and for step-down therapy following induction treatment with ...
4. Jan 9, 2019 — Amphotericin B is the initial drug of choice for blastomycosis in patients with severe illness (eg, rapidly progressive infections, CNS disease) ...
5. by SW Chapman · 2000 · Cited by 258 — Itraconazole has proven efficacy in the treatment of blastomycosis. Compared with ketoconazole, itraconazole is more readily absorbed, has enhanced antimycotic ...
6. Jul 3, 2023 — For people with mild to moderate cases of blastomycosis, doctors typically recommend the antifungal medication itraconazole. Doctors may ...

Differential Diagnosis of Blastomycosis

Blastomycosis, a fungal infection caused by Blastomyces species, can mimic various conditions, making its diagnosis challenging. The differential diagnosis for blastomycosis includes:

• Pneumonia: Blastomycosis may present as a community-acquired pneumonia, and it should be considered in the differential diagnosis of any patient with pneumonia that is not resolving or one who presents with acute respiratory distress syndrome (ARDS) [6].
• Tuberculosis: The symptoms of blastomycosis can overlap with those of tuberculosis, making it essential to consider both conditions in the differential diagnosis.
• Non-infectious pulmonary disease: Blastomycosis should also be considered in the differential diagnosis of non-infectious pulmonary diseases, such as lung cancer [3].
• Other causes of community-acquired pneumonia (CAP): The differential diagnosis for blastomycosis should include other common bacterial causes of CAP, including Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and others [4].

Key Points to Consider

• Blastomycosis is a fungal infection that can mimic various conditions, making its diagnosis challenging.
• The differential diagnosis for blastomycosis includes pneumonia, tuberculosis, non-infectious pulmonary disease, and other causes of CAP.
• Symptoms of blastomycosis can overlap with those of other conditions, making it essential to consider multiple possibilities in the differential diagnosis.

References

[1] Context result 4 [2] Context result 9 [3] Context result 3 [4] Context result 4