Blastomycosis

Blastomycosis is a rare infection caused by breathing in (inhaling) a fungus called Blastomyces dermatitidis, which is found in wood and soil.

Blastomycosis occurs in people living in the south-central and midwestern United States and Canada. The infection is seen in 1-2 out of every 100,000 people in areas where the fungus most frequently occurs. It is even less common outside those areas.

Being around infected soil is the key risk factor.

The disease usually affects people with weakened immune systems, such as those with HIV or organ transplant recipients. Men are more likely to be affected than women.

Lung infection may produce no symptoms, but when the infection spreads, skin lesions or bone lesions may appear and the bladder, kidney, prostate, and testes may be affected.

• Cough (may produce brown or bloody mucus)
• Shortness of breath
• Sweating
• Fever
• Fatigue
• General discomfort, uneasiness, or ill-feeling (malaise)
• Unintentional weight loss
• Joint stiffness and joint pain
• Muscle stiffness and pain
• Rash
• Skin lesions
• Chest pain

• History of living in an area where the fungus is commonly found
• Chest x-ray
• Tissue biopsy
• Skin biopsy
• Sputum culture and special stains

Medicines may not be needed for a blastomycosis infection that remains in the lungs, unless it becomes severe. When the disease is severe, or when it spreads outside of the lungs, the following medicines (anti-fungals) may be prescribed:

• Itraconazole
• Fluconazole
• Ketoconazole

Amphotericin B may be used for severe infections.

You should follow-up regularly with your doctor to make sure the infection doesn't return.

Patients with minor skin sores (lesions) and relatively mild lung infections usually recover completely. If the infection is not treated, it can become severe enough to cause death.

• Large sores with pus (abscesses)
• Return of the infection (relapse or disease recurrence)
• Unpleasant side effects to drugs such as amphotericin B

Call your health care provider if symptoms of blastomycosis occur.

Avoiding travel to areas where the infection is known to occur may help prevent exposure to the fungus, but this may not always be possible.