Last reviewed: November 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • recreational or occupational exposures
  • primary residence in or travel to endemic areas

Other diagnostic factors

  • male sex
  • age 30 to 50 years
  • constitutional symptoms
  • cough
  • skin lesions
  • animal exposure
  • bone or joint pain
  • GU symptoms
  • headache or focal neurologic complaints

Risk factors

  • male sex
  • recreational or occupational exposures
  • travel to or residence in an area of endemicity
  • immunocompromise

Diagnostic investigations

1st investigations to order

  • chest x-ray
  • sputum smear and culture
Full details

Investigations to consider

  • bronchoscopy
  • tissue biopsy or cytology (lung, skin, or bone)
  • arthrocentesis
  • fungal serology panel
  • Blastomyces dermatitidis antigen testing (urine, bronchoalveolar lavage, or serum)
  • fungal blood cultures
  • MRI brain
  • B dermatitidis PCR
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Medicine

Division of Infectious Diseases

Mayo Clinic

Rochester

MN

Disclosures

NC declares that he has no competing interests.

Professor of Medicine

Division of Infectious Diseases

Mayo Clinic

Rochester

MN

Disclosures

LB declares that he has received royalty payments for authorship duties on UpToDate, Inc., and that he has been editor-in-chief of the Massachusetts Medical Society and NEJM Journal Watch (infectious diseases).

Peer reviewers VIEW ALL

Assistant Professor of Medicine

Department of Medicine

Section of Pulmonary and Critical Care

University of Chicago

Chicago

IL

Disclosures

KH declares that he has no competing interests.

Associate Professor of Medicine

Stanford University

Stanford

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

Disclosures

WK declares that he has no competing interests.

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