Blastomycosis

Excerpt

Blastomycosis is a fungal infection caused by the organism Blastomyces dermatitidis, which is endemic in the soils of the Ohio and Mississippi River Valleys, Great Lakes region, and the southeastern United States. It most commonly presents as a pulmonary infection following the inhalation of spores, which may be asymptomatic and, therefore, undetectable, though severe, life-threatening complications like acute respiratory distress syndrome can occur. Extrapulmonary disease occurs in approximately 25% to 30% of patients after hematogenous dissemination from the lungs, with the skin being the most common site of extrapulmonary disease. Primary cutaneous blastomycosis, though rare, can occur due to direct inoculation after trauma to the skin. Unlike other deep fungal infections that occur predominantly in immunocompromised patients, blastomycosis also occurs in immunocompetent hosts.