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Infectious Disease Clinics of North... Jun 2021Blastomycosis is the fungal disease caused by thermally dimorphic fungi in the genus Blastomyces, with B dermatitidis complex causing most cases. It is considered... (Review)
Review
Blastomycosis is the fungal disease caused by thermally dimorphic fungi in the genus Blastomyces, with B dermatitidis complex causing most cases. It is considered hyperendemic in areas adjacent to the Great Lakes and along the St. Lawrence, Mississippi, and Ohio rivers, but definitive geographic distribution of blastomycoses remains obscure. Clinical presentation is variable. Disseminated blastomycosis with extrapulmonary manifestations is more common in immunosuppressed individuals. Culture positivity is required for definitive diagnosis, but compatible histology is often sufficient for presumptive diagnosis and initiation of treatment. Treatment should be provided to all symptomatic cases to prevent progression or recurrence.
Topics: Amphotericin B; Antifungal Agents; Blastomyces; Blastomycosis; Endemic Diseases; Humans; Itraconazole
PubMed: 34016289
DOI: 10.1016/j.idc.2021.03.013 -
Seminars in Respiratory and Critical... Feb 2020Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic... (Review)
Review
Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic fungi belonging to the genus . The genetic and geographic diversity of these pathogens is greater than previously appreciated. In addition to and the cryptic species , which cause blastomycosis in mid-western and various eastern areas of North America, atypical blastomycosis is occasionally caused by in western parts of North America and in Africa. Blastomycosis is acquired by inhalation of the conidia that are produced in the mold phase; in the lungs, temperature-dependent transformation occurs to the yeast phase. In this form, the organism is phagocytized by macrophages and can spread hematogenously to various organs causing disseminated infection. Pulmonary disease is most common and varies from mild, self-limited infection to severe, potentially fatal adult respiratory distress syndrome. Disseminated infection is manifested primarily by skin lesions, but many other organs can be involved. Diagnosis is established by growth of the organism in culture; however, a tentative diagnosis can be made quickly by histopathological identification of the classic yeast form in tissues or by finding antigen in urine or serum. Blastomycosis is treated initially with amphotericin B when the disease is severe, involves the central nervous system, or the host is immunosuppressed. Itraconazole is recommended for primary therapy in mild-to-moderate infection and for step-down therapy after initial amphotericin B treatment. Voriconazole and posaconazole can be used for patients in whom itraconazole is not tolerated.
Topics: Amphotericin B; Antifungal Agents; Blastomyces; Blastomycosis; Humans; Immunocompromised Host; Itraconazole; Triazoles; Voriconazole
PubMed: 32000282
DOI: 10.1055/s-0039-3400281 -
Infectious Disease Clinics of North... Mar 2016Blastomycosis is an endemic fungal infection due to Blastomyces dermatitidis that most commonly causes pneumonia; but the organism can disseminate to any organ system,... (Review)
Review
Blastomycosis is an endemic fungal infection due to Blastomyces dermatitidis that most commonly causes pneumonia; but the organism can disseminate to any organ system, most commonly the skin, bones/joints, and genitourinary tract. Both immunocompetent and immunocompromised persons can be infected, but more severe disease occurs in the immunocompromised. Blastomycosis can be diagnosed by culture, direct visualization of the yeast in affected tissue, and/or antigen testing. Treatment course and duration depend on severity of illness. For mild to moderate pulmonary disease the treatment is itraconazole. For severe blastomycosis, lipid formulation amphotericin B is given, followed by step-down therapy with itraconazole.
Topics: Antifungal Agents; Blastomycosis; Humans; Immunocompromised Host
PubMed: 26739607
DOI: 10.1016/j.idc.2015.10.002 -
Compendium (Yardley, PA) Aug 2011For more than 100 years, blastomycosis has been recognized as causing significant morbidity and mortality in people and dogs. The disease is rare in cats. Isolation of... (Review)
Review
For more than 100 years, blastomycosis has been recognized as causing significant morbidity and mortality in people and dogs. The disease is rare in cats. Isolation of the organism is difficult, and novel methods to culture environmental samples are forthcoming. The most significant clinical dilemma is the inability to make a timely diagnosis when multiple cytologic samples are unrewarding. This article reviews the literature on advances in epidemiology and serology, clinical presentations, new antifungal drugs, and progress in formulating a vaccine.
Topics: Animals; Antifungal Agents; Blastomycosis; Cat Diseases; Cats; Dog Diseases; Dogs
PubMed: 21870343
DOI: No ID Found -
Clinics in Dermatology 2012Blastomycosis is a systemic mycosis with a high prevalence in the Midwest of the United States. The fungus inhabits soil, and human infection occurs through inhalation.... (Review)
Review
Blastomycosis is a systemic mycosis with a high prevalence in the Midwest of the United States. The fungus inhabits soil, and human infection occurs through inhalation. Its asexual phase is called Blastomyces dermatitidis and its sexual phase, Ajellomyces dermatitidis. It is more common in men. Signs and symptoms are usually severe, starting with an infection resembling pneumonia that later disseminates to the skin, bones, and central nervous system. Infection in dogs is common in endemic areas. The diagnosis can be achieved by identifying the organism with direct microscopy, culture, histopathology, serologic tests, and molecular techniques, although these are still in trial phase. The treatments of choice are azoles (itraconazole, fluconazole, and posaconazole), and in severe cases, amphotericin B.
Topics: Animals; Antifungal Agents; Blastomycosis; Dermatomycoses; Female; Geography; Humans; Male; Sex Distribution
PubMed: 23068144
DOI: 10.1016/j.clindermatol.2012.01.002 -
Journal of Veterinary Dentistry Sep 2022A case of localized oral mandibular blastomycosis is described in a five-year-old dog. Complete resolution of clinical signs and oral radiographic changes were seen... (Review)
Review
A case of localized oral mandibular blastomycosis is described in a five-year-old dog. Complete resolution of clinical signs and oral radiographic changes were seen following itraconazole therapy at 5 mg/kg/day for four and a half months. The patient remained free of at the one year follow up based on the Mira Vista urine antigen test by EIA (Enzyme Immunoassay). A literature review of localized blastomycosis cases in humans and dogs was performed, available diagnostic tests evaluated, and treatment comparisons made.
Topics: Animals; Blastomyces; Blastomycosis; Dog Diseases; Dogs; Humans; Immunoenzyme Techniques; Itraconazole
PubMed: 35502840
DOI: 10.1177/08987564221098166 -
CMAJ : Canadian Medical Association... Jul 2023
Topics: Humans; Blastomycosis
PubMed: 37524399
DOI: 10.1503/cmaj.230269 -
Critical Reviews in Microbiology Apr 1982Blastomycosis is the infection caused by the dimorphic fungus Blastomyces dermatitidis. The fungus was believed to be limited in distribution to North America but is... (Review)
Review
Blastomycosis is the infection caused by the dimorphic fungus Blastomyces dermatitidis. The fungus was believed to be limited in distribution to North America but is found in Africa and northern South America, too. The exact natural habitat of B. dermatitidis is still uncertain with only rare reported isolation of the fungus from the environment. The inability to recover the organism from nature along with the absence of both a reliable skin test antigen and a sensitive serological test have significantly restricted our understanding of the epidemiology and the full clinical spectrum of blastomycosis. An accidental laboratory infection and several common source epidemics have enabled us to recognize that blastomycosis may be a self-limited pulmonary infection. Endogenous reactivation and opportunistic infections have been newly appreciated as clinical presentations of blastomycosis. This report will review blastomycosis with particular emphasis on these recent developments.
Topics: Adult; Amphotericin B; Animals; Antibodies, Fungal; Arthritis, Infectious; Blastomyces; Blastomycosis; Bone Diseases; Central Nervous System Diseases; Child; Dermatomycoses; Disease Outbreaks; Female; Humans; Lung Diseases, Fungal; Male; United States; Urologic Diseases
PubMed: 7049575
DOI: 10.3109/10408418209104489 -
Clinical Infectious Diseases : An... Mar 1992Blastomycosis is a rare but important fungal infection that occurs primarily in the south central and midwestern United States. Epidemics of blastomycosis related to a... (Review)
Review
Blastomycosis is a rare but important fungal infection that occurs primarily in the south central and midwestern United States. Epidemics of blastomycosis related to a point-source exposure include patients of all ages and both sexes; however, cases of endemic blastomycosis are usually in young to middle-aged adults and are reported more for men than for women. Pneumonia is the most common manifestation of blastomycosis, and the lungs are almost always the organ initially infected. Skin, bone, prostate, and central nervous system are the next most frequently infected organs in descending order. Amphotericin B is curative, but because of its toxic effects, oral agents have been investigated as therapy for blastomycosis. ketoconazole should replace amphotericin B as therapy for blastomycosis that is not life threatening. Itraconazole is an experimental agent that is perhaps even more effective than ketoconazole. The therapeutic usefulness of fluconazole for blastomycosis remains unproven. For patients with life-threatening or central nervous system blastomycosis, amphotericin B remains the treatment of choice.
Topics: Amphotericin B; Antifungal Agents; Blastomycosis; Disease Outbreaks; Humans; Itraconazole; Ketoconazole; United States
PubMed: 1314106
DOI: 10.1093/clinids/14.supplement_1.s82 -
JAMA Dermatology Sep 2022
Topics: Antifungal Agents; Blastomycosis; Humans
PubMed: 35947397
DOI: 10.1001/jamadermatol.2022.3151