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Blastomycosis (North American Blastomycosis)

 

 

 

 

 

 

What is it?

 

It is a flu-like illness with fever, chills, arthralgia (joint pain), myalgia (muscle pain), headache, and a nonproductive cough which resolves within days. A fungal infection caused by the organism Blastomyces dermatitidis. Endemic to portions of North America, blastomycosis causes clinical symptoms similar to histoplasmosis.

 

 

 

What are the symptoms?

• Bone and joint pain
• Chest pain
• Cough (may produce brown or bloody mucus)
• Fatigue
• Fever and night sweats
• General discomfort, uneasiness, or ill feeling (malaise)
• Muscle pain

 

 

 

How to treat it?


All patients with extrapulmonary disease or progressive pulmonary disease require therapy:

1. Either a lipid formulation amphotericin B or amphotericin B deoxycholate should be given to patients with moderately severe to severe pulmonary or disseminated infection.
2. A lipid formulation of amphotericin B is preferred for patients with central nervous system (CNS) infection.
3. An azole, usually itraconazole, is preferred for patients with mild to moderate disease not involving the CNS.

Immune status to the patients:  
— Some immunocompetent patients with acute infection confined to the lungs spontaneously clear the infection and may not need treatment. In contrast, all immunocompromised patients should be treated, most frequently with amphotericin B.

 

 

 



Life cycle of a Blastomyces dermatitis

 

Facts


40% immunocompromised individuals have CNS involvement and present as brain abscess, epidural abscess or meningitis
You may not have any symptoms if the infection remains in the lungs. The following symptoms can develop if the infection spreads to other parts of the body:
Lung infection may not cause any symptoms. Symptoms may be seen if the infection spreads.