• Robert W. Bradsher
  • J. Ryan Bariola


Blastomycosis is caused by the dimorphic fungus Blastomyces dermatitidis. The organism exists in nature in the mould or mycelial phase and converts to the parasitic or yeast phase at body temperature. Epidemics of blastomycosis after a point-source exposure have been described, but most cases occur sporadically in the endemic areas. B. dermatitidis can cause an infection with a subclinical illness and subsequent protection against infection afforded by cellular immune mechanisms. Patients infected with B. dermatitidis can present with pneumonia or with extrapulmonary disease, or both. Lung involvement often mimics acute bacterial pneumonia, lung cancer, or tuberculosis. Skin lesions, presenting as either verrucous or ulcerative lesions, are the most common extrapulmonary manifestation, followed by bone, prostate, and central nervous system (CNS) disease. Diagnosis is usually confirmed by visualization of the yeast in smears or in tissue specimens, or by culture. Itraconazole has been shown to be the drug of choice for both pulmonary and extrapulmonary infection, except in cases of life-threatening infection, in which case, amphotericin B is recommended.


Acute Respiratory Distress Syndrome Antifungal Therapy Pyoderma Gangrenosum Tumor Necrosis Factor Antagonist Yeast Phase 
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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care SystemLittle RockUSA

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