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Blastomycosis

Last reviewed: 23 Oct 2024
Last updated: 12 Jul 2024

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

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

Risk factors

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

Diagnostic tests

1st tests to order

  • Blastomyces dermatitidis enzyme immunoassay (EIA) urine antigen testing
  • chest x-ray
  • respiratory tract specimen smear and culture
Full details

Tests to consider

  • bronchoscopy
  • tissue biopsy or cytology (lung, skin, or bone)
  • arthrocentesis
  • fungal serology panel
  • fungal blood cultures
  • MRI brain
  • B dermatitidis polymerase chain reaction
Full details

Treatment algorithm

ONGOING

ambulatory immunocompetent nonpregnant adults

hospitalized immunocompetent nonpregnant adults

immunosuppressed nonpregnant adults with or without CNS disease

pregnant

neonates <30 days old

infants/children ≥30 days old

Contributors

Authors

Nathan Cummins, MD

Associate Professor of Medicine

Division of Infectious Diseases

Mayo Clinic

Rochester

MN

Disclosures

NC declares that he has no competing interests.

Larry Baddour, MD

Professor Emeritus of Medicine

Division of Infectious Diseases

Mayo Clinic

Rochester

MN

Disclosures

LB declares that he has no competing interests.

Peer reviewers

Adriana M. Rauseo, MD

Assistant Professor of Medicine

Division of Infectious Diseases

Department of Internal Medicine

Washington University in St Louis

St Louis

MO

Disclosures

AMR declares that she has no competing interests.

  • Blastomycosis images
  • Differentials

    • Community-acquired pneumonia
    • Histoplasmosis
    • Coccidioidomycosis
    More Differentials
  • Guidelines

    • Clinical testing guidance for coccidioidomycosis, histoplasmosis, and blastomycosis in patients with community-acquired pneumonia for primary and urgent care providers
    • Global guideline for the diagnosis and management of the endemic mycoses
    More Guidelines
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