Blastomycosis Research Articles

A rare clinical presentation of blastomycosis

North American blastomycosis is a multisystem disease, primarily affecting the lungs and skin. The skeleton is affected in approximately 50% of cases. Bone symptoms as the primary clinical complaint are exceedingly rare. Two such cases are presented together with a brief discussion of this rare disease.

Mouse model of pulmonary blastomycosis: utility, simplicity, and quantitative parameters.

A murine model of pulmonary mycotic disease using Blastomyces dermatitidis is defined quantitatively. Intranasal inoculation with yeasts avoids delays in growing microconidia and can be performed with routine precautions without sophisticated biohazard facilities. The particles rapidly reach the bronchioles and alveoli, producing a progressive focal pneumonia, studied histologically. In vitro growth conditions are defined to titer inocula reproducibly with visual methods. Median survival can be titrated with the challenge inocula. Although initial postchallenge lung cultures are not always positive, replication eventually proceeds, at a rate defined for various challenge sizes, to a ceiling of 10(7) to 10(8) colony-forming units per g of tissue incompatible with life. Lung weight correlates closely with colony-forming units per g above a threshold. Lethality correlates with initial body weight and with age. During the course of infection, weight is an accurate predictor of mortality. Extrapulmonary dissemination occurs as a premortem event in protracted infections. A wide variation in fungal strain virulence is documented. Quantification of these features of the model makes it useful for study of host response or therapeutic intervention, because efficacy can be related to stage of disease and parasitic burden.

The association of adenocarcinoma of the lung and blastomycosis from an unusual geographical location

A case of North American blastomycosis acquired outside the American continent and presenting with a left hilar mass is reported. The progressive hilar enlargment, despite adequate antifungal treatment, raised the possibility of drug resistance, concomitant tuberculosis and carcinoma. Non-invasive diagnostic studies including cultures, cytology and fibreoptic bronchoscopy were negative. On thoracotomy, both blastomycosis and a poorly undifferentiated adenocarcinoma were evident.

Disseminated North American Blastomycosis

Adrenal involvement in cases of disseminated North American blastomycosis occurs frequently, but clinically substantive adrenal insufficiency is rare. An unusual case of disseminated blastomycosis with clinical manifestations of adrenal insufficiency was found. One should be alert to the symptoms of adrenal insufficiency that may develop in patients with disseminated mycoses. (<i>JAMA</i>238:2629-2630, 1977)

Addisonʼs Disease Secondary to North American Blastomycosis

Reported is the fifth known case of Addison's disease due to adrenal involvement by North American blastomycosis (Blastomyces dermatitidis infection). The fact that amphotericin B therapy precipitated an addisonian crisis suggests that patients with disseminated blastomycosis should have their adrenal function and reserve evaluated before undergoing systemic chemotherapy.

An urban epidemic of North American blastomycosis.

Five culturally proved cases of blastomycosis occurred in a 9-month period during 1974 and 1975 in a western suburb of Chicago. All patients lived within a 1-mile radius of the center of Westmont, Ill. (population, 12,000). Three of these patients lived in adjacent buildings in the same apartment complex. None of the patients had significant outdoor exposure. Dust from a nearby construction site was postulated as a possible common source, although soil cultures from the area were negative. This is the third chronologic epidemic of the blastomycosis; a fourth one has been reported. It is the only outbreak to occur in a major metropolitan area.

Disseminated pulmonary blastomycosis in an immunosuppressed patient. Diagnosis by fiberoptic bronchoscopy.

A 73-year-old man with malignant lymphoma who was undergoing treatment with systemic chemotherapy presented with an acute, febrile illness associated with cough and sputum production. The patient developed bilateral, diffuse, pulmonary interstitial infiltrates with rapidly progressive respiratory insufficiency. The diagnosis was made by demonstrating Blastomyces dermatitidis in bronchial brush and transbronchial lung biopsy specimens obtained through fiberoptic bronchoscopy.

Blastomycosis of the Genitourinary Tract

In a retrospective study of 51 cases of systemic North American blastomycosis 11 patients were found to have genitourinary tract involvement, the prostate and epididymis being most commonly affected. Diagnosis was made by culture of the fungus from urine, abscess or prostate secretions, morphologic identification of the characteristic organism in urine or secretions, or histologic examination of tissue specimens. Treatment with amphotericin B reduced the mortality rate of 90 per cent to as low as 10 per cent. Long-term followup is necessary because of a relapse rate of 10 to 15 per cent.

North American blastomycosis in Zambia.

North American blastomycosis in Zambia.

Systemic North American Blastomycosis with Orbital Involvement

Systemic North American Blastomycosis with Orbital Involvement

North American blastomycosis in Iowa review of 34 cases

We have reviewed 34 patients with blastomycosis seen from 1937–1971 at the University of Iowa Hospitals, 29 men and 5 women, ages 19–78; 86 per cent of our patients were followed to death or for 5 or more years after hospitalization. Thirty-six per cent had a probable occupational soil exposure. A majority of patients had symptoms for 4–12 months before diagnosis. Fever was unusual and symptoms varied according to the anatomical site involved. The disease has been analyzed in patients with cutaneous, pulmonary, osseous, genito-urinary and disseminated blastomycosis. The disease should be diagnosed by culture, but the presence of round, thick-walled, single-budding yeast in KOH skin scraping preparations is highly suggestive. Treatment with dihydroxystilbamidine or Amphotericin B has reduced the recurrence rate from 20 per cent to 9 per cent and the death rate from 8 per cent to zero. Surgical treatment by lobectomy was done in 3 patients.

Blastomyces dermatitidis in cytologic preparations.

The recognition of Blastomyces dermatitidis in Papanicolau preparations of sputum was applied to the diagnosis of pulmonary blastomycosis in 15 of 29 cases, and the diagnosis was confirmed in 11 instances. A presumptive etiologic diagnosis was obtained as promptly as the direct microscopic examination of wet preparation. This method was convenient because of the ready availability of service from the cytology laboratory as compared with that of the mycology laboratory service, and because of the frequency with which the need for the differentiation of pulmonary neoplasm from blastomycosis occurred. It was particularly valuable in patients for whom thoracotomy was being considered for pulmonary lesions of unknown etiology. If used with discretion and confirmed by culture, the examination of cytologic preparations of sputum promises to be the most frequent means of presumptive etiologic diagnosis in pulmonary blastomycosis.

North American Blastomycosis

The case of a patient suffering from North American blastomycosis is reported. The infection was contracted in Gambia, West Africa. The diagnosis was established by identification of the organism in histologic sections and in cultures at room temperature and at 37°C. The patient was treated with amphotericin B. The epidemiology of this infection is discussed.

Primary Cutaneous Blastomycosis

Primary Cutaneous Blastomycosis

Aspergillomas occurring in blastomycotic cavities.

Aspergillomas developed in pulmonary cavities produced by blastomycosis in 2 patients within two years of apparently successful treatment of blastomycosis with intravenously administered amphotericin B. The patients have been followed up for 76 and 12 months, respectively. Aside from the appearance of minimal hemoptysis in both, the presence of aspergillomas was not deleterious to these patients.

Primary Cutaneous Blastomycosis

Primary cutaneous (accidental transcutaneous) infection with<i>Blastomyces dermatitidis</i>occurred in a patient. After accidental inoculation by a culture-carrying needle, a draining sore developed on the point of contact without demonstrable progression in lymph channels or lymph nodes. The lesions healed spontaneously. Therefore, primary cutaneous disease differs from the ordinary pulmonary infection by the development of a local chancre, generally with lymphangitis and lymphadenitis.

Primary cutaneous blastomycosis

Primary cutaneous blastomycosis

Paracoccidioidomycosis in the United States (South American Blastomycosis).

The diagnosis of paracoccidioidomycosis was made in the case of a hospitalized patient in New Orleans. The biopsy showed multiple budding and variations in fungus cell size. In the hematoxylin-eosin sections, the budding was not obvious and the first suggestion offered was that it was North American blastomycosis. The Grocott-Gomori methenamine silver stain demonstrated the multiple budding and variation in cell size to better advantage. Cultures revealed<i>Paracoccidioides brasiliensis</i>, skin tests were positive to paracoccidiodin, and results of serologic tests were positive. The patient had worked in South America for a number of years, though he was a native of the United States.

Deep mycoses reported from Australia and New Guinea during the years 1956 to 1969.

The incidence of deep mycoses, both primary and secondary, reported in Australia and New Guinea during the years 1956 to 1969, is reviewed. No cases of North American blastomycosis or South American blastomycosis (paracoccidioidomycosis) have been found in this survey. The same is true for coccidioidomycosis, although Symmers (1968) has reported that an Australian man, arriving in London after a long period of travel, was found to have coccidioidomycosis. Symmers, however, believes that this infection was acquired not in Australia, but probably in one of the countries visited on the journey. Only four cases of histoplasmosis have so far been reported in Australia. It is suggested that some, at least, of these deep fungal infections should be made notifiable in Australia.

Progressive Hoarseness and Aphonia Due to Blastomycosis

No AccessJournal of Speech and Hearing DisordersForum1 Nov 1970Progressive Hoarseness and Aphonia Due to Blastomycosis Eugene M. Batza and Nathan A. Geurkink Eugene M. Batza Cleveland Clinic Foundation, Ohio Google Scholar More articles by this author and Nathan A. Geurkink Cleveland Clinic Foundation, Ohio Google Scholar More articles by this author https://doi.org/10.1044/jshd.3504.340 SectionsAboutPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In Additional Resources FiguresReferencesRelatedDetailsCited ByLanguage, Speech, and Hearing Services in Schools35:4 (299-307)1 Oct 2004Laryngeal Structure and Function in the Pediatric LarynxChristine M. Sapienza, Bari Hoffman Ruddy and Susan Baker Volume 35Issue 4November 1970Pages: 340-343 Get Permissions Add to your Mendeley library History Published in issue: Nov 1, 1970 Metrics Topicsasha-topicsleader-topicsasha-article-typesCopyright & PermissionsCopyright © 1970 American Speech-Language-Hearing AssociationLoading ...