Primary cutaneous blastomycosis is a rare presentation of infection caused by direct inoculation of a wound. We present a 61-year-old male with an extensive history of wound dehiscence and wound care noncompliance after a bite from a brown recluse spider on the left thigh while on vacation in Cape Cod in September of 2020. After antibiotic therapy and culture, treatment involved debridement, split thickness skin grafting, strict wound vacuum-assisted closure care, and oral itraconazole. This brief demonstrates a case of blastomycosis arising from trauma in a non-endemic region for infection and serves as an example of successful management of the longstanding wound.
Keywords: blastomycosis; nonhealing wound; spider bite; wound management.