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Blastomycosis

Dennis J. Baumgardner, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Systemic pyogranulomatous disease caused by inhalation of spores (conidia) from the fungus Blastomyces dermatitidis or Blastomyces gilchristii (1,2)

  • ≥50% asymptomatic or minimally sym...

DIAGNOSIS

  • Acute blastomycosis described as a flulike illness with cough, fever, chest pain, myalgias

  • Pulmonary blastomycosis is generally differentiated into acute and chronic disease based on symptoms...

TREATMENT

  • Antifungal therapy: recommended for moderate to severe pneumonia, disseminated infection, or immunocompromised patients

  • In the immunocompetent host, acute pulmonary blastomycosis can be mild ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • All azoles reported to cause hepatitis. Measure hepatic enzymes before initiating and periodically during therapy.

  • Reactivation may occur with or without treatment...

REFERENCES

Castillo CG, Kauffman CA, Miceli MH. Blastomycosis. Infect Dis Clin North Am.  2016;30(1):247–264.  [View Abstract]
Smith JA, Gauthier G. New developments in blastomycosis. Semin Resp...

ADDITIONAL READING

Plamondon M, Lamontagne F, Allard C, et al. Corticosteroids as adjunctive therapy in severe blastomycosis-induced acute respiratory distress syndrome in an immunosuppressed patient....

CODES

ICD10

  • B40.9 Blastomycosis, unspecified

  • B40.2 Pulmonary blastomycosis, unspecified

  • B40.7 Disseminated blastomycosis

  • B40.3 Cutaneous blastomycosis

  • B40.81 Blastomycotic meningoencephalitis

  • B40.89 Other f...

CLINICAL PEARLS

  • Consider blastomycosis in patients presenting with flulike respiratory illness.

  • Consider blastomycosis in patients with overwhelming pneumonia and in the differential diagnosis for pati...

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