Introduction
Etiologic agent
Blastomycosis B.dermatitidis
Epidemiology
Disseminated disease may occur even in immunocompetent patients. Generally more severe in immunocompromised patients
Pathogenesis
Approach to the patient
Clinical manifestations
- Inhalation from soil.
- Pulmonary
- Local lung infection ~ pneumonia, granuloma
- Disseminated
- Common and severe.
- Usually skin and bone(lytic).
- Skin: wartlike lesions, violaceous nodules, skin ulcers
- Bone: Osteomyelitis
- CNS: meningitis, epidural or brain abscesses
Diagnosis
cf) hilar adenopathy is more suggestive of histoplasmosis
Doubly refractile wall, single broad-based bud
Treatment
Amphotericin B, Fluconazole (for meningeal infection)
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