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Blastomyces dermatitidis is dimorphic, meaning it exists in two forms: a mold form in the environment (at cooler temperatures) and a yeast form inside the human body (at body temperature, 37°C).

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People who work outdoors in areas where Blastomyces is common, such as construction workers, farmers, and landscapers, are at higher risk for exposure, especially when disturbing soil or organic material.

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Blastomycosis is most commonly found in North America, particularly around the Great Lakes, Ohio River Valley, and parts of Canada. It can also be found in parts of Africa and the Middle East.

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Under the microscope, Blastomyces dermatitidis displays distinct features that help in diagnosing blastomycosis:

Yeast form (found in clinical samples like sputum, tissue, or skin lesions):

Large, round to oval cells (8-15 micrometers).

Broad-based budding: The daughter cell (bud) attaches to the parent cell at a wide base, which is a key diagnostic feature.

Thick, refractile cell wall.

Mold form (found in the environment, not typically in human tissue):

Septate hyphae with conidia (spores) at the tips of the hyphae.

Staining:

Gram stain: Yeast cells are gram-positive but may not show detailed features.

Special stains (GMS, PAS): These stains clearly highlight the broad-based budding yeast and the cell wall.

These microscopic characteristics—especially broad-based budding—are critical for identifying Blastomyces in clinical specimens.

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1. Pulmonary (Lung) Blastomycosis

Most common form of blastomycosis, affecting the lungs when spores are inhaled.

Symptoms include cough, fever, chest pain, shortness of breath, and night sweats.

Can mimic other lung diseases, like pneumonia, so diagnosis is based on tests, such as sputum samples or imaging.

2. Cutaneous (Skin) Blastomycosis

Affects the skin, causing lesions or ulcers.

Skin lesions are often round, raised, and firm, and may develop weeks or months after initial infection.

In severe cases, skin lesions can become painful or ulcerated.

3. Disseminated Blastomycosis

Occurs when the infection spreads beyond the lungs or skin to other parts of the body, such as bones, joints, or the central nervous system (brain and spinal cord).

Can cause symptoms like bone pain, joint pain, neurological symptoms (headaches, confusion), and even life-threatening conditions if untreated.

Most commonly affects the bones, brain, and genitourinary system (e.g., bladder, prostate).

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There’s no vaccine. To reduce the risk, avoid disturbing soil in areas where the fungus is common. Wearing masks when working in high-risk areas can also help.

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Treatment involves antifungal medications:

Mild cases: Oral antifungals like itraconazole.

Severe cases: Intravenous antifungals like amphotericin B, followed by oral antifungals.

Treatment typically lasts for several months.

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Symptoms can vary, but common ones include:

Lung symptoms: Cough, fever, chest pain, shortness of breath, and night sweats.

Skin symptoms: Painless or painful skin lesions that might be raised and firm.

Severe cases: If the infection spreads, it can affect bones, joints, or even the brain, causing headaches, confusion, and pain.

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You can get blastomycosis by inhaling spores from disturbed soil, particularly during activities like digging or working outside in certain regions of North America (like the Great Lakes and Ohio River Valley).

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Blastomycosis is a fungal infection caused by the fungus Blastomyces dermatitidis. It usually affects the lungs but can spread to other parts of the body like the skin, bones, and brain.