BLASTOMYCOSIS

General Information

DEFINITION--An infectious, fungus disease that starts in the lungs. Occasionally it spreads through the bloodstream to other body parts--especially the skin. Blastomycosis is not contagious from person to person, but can be transmitted through bites from infected dogs.

BODY PARTS INVOLVED--Lungs; mouth; skin and tissue below the skin; prostate; epididymis.

SEX OR AGE MOST AFFECTED--Both sexes, but most common in men from ages 20 to 40.

SIGNS & SYMPTOMS--

The following symptoms begin slowly:

• Cough, either dry and non-productive or with sputum.
• Chest pain.
• Chills, fever and drenching sweats.
• Shortness of breath.
• If skin involved, may have lesions or abscesses.

CAUSES--Infection with the fungus, Blastomyces dermatitidis, found in wood and soil. There may be some association with beaver huts. Skin lesions occur most commonly in gardeners or farmers, but the natural source of this fungus is unknown.

RISK INCREASES WITH

• Gardening and farming, especially in Southeastern states and the Mississippi River valley of the U.S.
• Diabetes mellitus.
• Use of immunosuppressive drugs.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory cultures of skin lesion, pus, sputum or blood to identify the fungus; biopsy of tissue from the skin or lungs; chest x-ray.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for intensive care, if the lung infection spreads to other body parts.
• Self-care after treatment.

POSSIBLE COMPLICATIONS--

Spread to other body parts, with serious illness and death. If the infection spreads, the following may appear:

• Pain in long bones.
• Skin lesions that begin as small papules (small, raised bumps on the skin) or pustules (small white blisters with pus) on exposed skin surfaces. They spread slowly. When fully developed, the lesions become crusted ulcers with sloping, reddish-purple borders.
• Swelling and painful, tender nodules in the scrotum.

PROBABLE OUTCOME--This fungus can cause severe, debilitating illness that may be fatal without treatment. With intensive treatment, it is usually curable in several weeks.

How To Treat

GENERAL MEASURES--

• Weigh daily and keep a weight chart. An unexplained weight loss might indicate the infection has spread.
• Keep follow-up appointments with the doctor. It is important to monitor the effectiveness of the treatment and watch for side effects or adverse reactions from the medications.
• Heat and elevation may be helpful for joint pain.

MEDICATION--For severe cases, your doctor may prescribe potent antifungal drugs, such as ketoconazole and amphotericin B.

ACTIVITY--Rest in bed during the acute stage. Resume activities gradually as your strength returns.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of blastomycosis.
• Any of the following occurs during treatment: Weight loss. Fever. Diarrhea that cannot be controlled with home remedies. Severe headache and stiff neck.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.