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Blastomycosis

Theresa A. Townley, MPH, MD and Stephen James Cooper, MPH, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A fungal infection caused by Blastomyces spp., a thermally dimorphic fungi that grows as a filamentous mold in the environment and as a yeast in human tissue (1) (2)

  • Infection is oft...

DIAGNOSIS

  • Diagnosis requires a high index of suspicion and delay in diagnosis is common, adding to morbidity/mortality.

  • High percentage (>50%) of infected persons may have subclinical or asymptomati...

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

1
Castillo  CG, Kauffman  CA, Miceli  MH. Blastomycosis. Infect Dis Clin North Am.  2016; 30(1): 247– 264.  [View Abstract] ...

ADDITIONAL READING

  • Dukik K, Munoz JF, Jiang Y, et al. Novel taxa of thermally dimorphic systemic pathogens in the Ajellomycetaceae ( Onygenales) . ...

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 with overwhelming pneumonia and in the differential diagnosis for patients with apparent antibiotic failure in the setting of routine community-acqui...

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