BLASTOMYCOSIS

(North American Blastomycosis; Gilchrist's Disease)

 Basic information

description

Blastomycosis is a rare infectious fungal disease that starts in the lungs. It can occasionally spread through the bloodstream to other body parts, especially the skin. Higher rates of the disease are found in parts of the south-central, south-eastern, and mid-western states and the Great Lakes area of the United States and Canada. It is also found in Central and South America and parts of Africa.

FREQUENT SIGNS & SYMPTOMS

• About 50% of those infected have no symptoms.
• Symptoms may begin slowly or may be sudden. They are often flu-like.
• Cough, either wet or dry.
• Chest pain.
• Chills, fever, and sweats.
• Shortness of breath.
• Fatigue, loss of appetite.
• May have bumps or sores on the skin.

causes

Infection with Blastomyces dermatitidis. It is a fungus found in moist soil that has decomposing organic debris. The infection is spread by breathing in airborne spores of the fungus after disturbance of contaminated soil. Symptoms may appear between 3 and 15 weeks after exposure. Blastomycosis is not known to be transmitted from person to person. Animals such as dogs and cats can become infected also.

risk increases with

• Exposure to soils where the fungus is located (e.g., farmers, forestry workers, hunters, and campers).
• Weak immune system due to illness or drugs.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

Cure rates are high, and the treatment (which may take months) is usually well tolerated.

possible complications

• Complications are more likely in those with weak immune systems due to illness or drugs.
• If not treated, it can spread to other body parts and lead to serious illness and even death. Most often, it involves the skin (and tissue below the skin). Small bumps develop and over time turn into open sores. Other complications can occur in the lungs, bones, scrotum, and prostate.
• Relapse can occur in up to 10% of patients.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam. Questions will be asked about your symptoms, medical history, and lifestyle. Medical tests may include blood tests and lab cultures (of the skin lesions, pus, saliva, or lung secretions). X-rays or a biopsy may be done. Biopsy is when a small amount of tissue is removed for viewing under a microscope.
• Treatment is with drugs and other supportive care. Some patients with mild symptoms may require no treatment. The infection can clear on its own.
• Hospital care may be needed for severe symptoms.
• Keep follow-up appointments with your health care provider. It is important to monitor the treatment and watch for side effects or reactions from the drugs.

medications

An antifungal drug given orally is the treatment of choice for most forms of the disease. For more severe symptoms, the drugs may be given through a vein (IV).

activity

Rest in bed if symptoms are more severe. Resume your activities slowly as strength returns.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of blastomycosis.
• Any of the following occur during treatment:
  • Weight loss.
  • Fever.
  • Diarrhea that cannot be controlled with self-care.
  • Severe headache and stiff neck.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: