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Blastomycosis

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Symptoms

About half of people who are infected with the fungus Blastomyces have symptoms. The symptoms of blastomycosis are often similar to the symptoms of other lung infections, and can include:

Fever

Cough

Shortness of breath

Night sweats

Muscle aches or joint pain

Weight loss

Chest, rib, or back pain

Fatigue (extreme tiredness)

Some people with blastomycosis may also develop skin lesions, such as raised bumps, blisters, or ulcers.

Symptoms of blastomycosis usually appear between 3 weeks and 3 months after a person breathes in the fungal spores.

Severe blastomycosis

In some people, particularly those who have weakened immune systems, blastomycosis can spread from the lungs to other parts of the body, such as the skin, bones and joints, and the central nervous system (the brain and spinal cord).

Diagnosis and testing
What to expect
Healthcare providers use medical and travel history, symptoms, physical examinations, and laboratory tests to diagnose blastomycosis. They will likely test for blastomycosis by taking a blood sample or a urine sample and sending it to a laboratory.

Healthcare providers may do imaging tests such as chest x-rays or CT scans of lungs. They may also collect a sample of fluid from your respiratory tract (airway) or perform a tissue biopsy, in which a small sample of affected tissue is taken from the body and examined under a microscope. Laboratories may also see if Blastomyces will grow from body fluids or tissues (this is called a culture).
When to test
People should get tested for blastomycosis when they have been to an area where the fungus lives in the last 3 weeks to 3 months and:

have symptoms of pneumonia,

have been given antibiotics that are not working.

Healthcare providers may test for blastomycosis if a patient has new skin lesions (such as raised bumps, blisters, or ulcers) or has been in an area or participated in an activity that has been linked to other people who recently got blastomycosis.
Test results
The length of time it takes for test results to come back depends on the type of test. Results from a blood test or a urine test are usually available in a few days. When healthcare providers send a sample to a laboratory to be cultured, the results could take a couple of weeks.

Treatment

Most people who have blastomycosis will need antifungal treatment.

Most people who have symptoms from blastomycosis will need treatment with prescription antifungal medication. Itraconazole is a type of antifungal medication that is typically used to treat mild to moderate blastomycosis. Amphotericin B is usually recommended for severe blastomycosis. Your doctor may test your blood to check if there is enough antifungal medication in your body. Depending on the severity of the infection and your immune system, the length of treatment can range from six months to one year.

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The symptoms of blastomycosis are often similar to the symptoms of flu or other lung infections, and can include fever, cough, night sweats, muscle aches or joint pain, weight loss, chest pain, and fatigue.

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Blastomycosis is the onset of infection caused by inhaling the Blastomyces dermatitidis fungus, which is commonly found in decaying wood and soil. It is a very rare disease as it is only contracted in the central and southeastern United States, as well as Canada, India, Israel, Saudi Arabia, & Africa.

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Blastomyces Dermatitidis Fungus

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1) Chest Pain

2) Cough accompanied by brown and/or bloody mucus

3) Fatigue

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Diagnosis: a urine or blood sample is normally taken to be tested for the causative agent, but chest x-rays, a culture, fluid sample from respiratory tract, or tissue biopsy may also be collected. Often you are asked about your travel history since it is a rare disease, having the ability to only be contracted in certain parts of the world.

Treatment: the most common course of treatment is an anti-fungal treatment

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People who travel to areas where the disease are more likely to contract it. Additionally, individuals with weakened immune systems or individuals who are pregnant have a greater risk of developing a more severe type of Blastomycosis. These individuals might be cautioned to take preventative measures and not participate in activities such as camping, hunting, etc. in an area where the disease is known to be prevalent.

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Although rare, a recent success regarding Blastomycosis is the succession of treatment in spinal infections caused by the fungal disease. Overall, spinal infections can be tricky and are accompanied by a shocking mortality rate. When caught early on, and with proper measures taken, anti-fungal treatments seem to do the job. Sometimes treatment also includes surgery, but the ultimate success with Blastomycosis right now, is having medication that can potentially rid the body of infection.

Citation: Gonzalez GA, Porto G, Tecce E, Oghli YS, Miao J, O'Leary M, Chadid DP, Vo M, Harrop J. Advances in diagnosis and management of atypical spinal infections: A comprehensive review. N Am Spine Soc J. 2023 Sep 28;16:100282. doi: 10.1016/j.xnsj.2023.100282. PMID: 37915965; PMCID: PMC10616400.

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MD at Jefferson Health, Neurology Department

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James S Harrop MD is a Jefferson Health Provider

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Blastomycosis in Minnesota: Kevin’s Story

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More than 100 cases of rare fungal infection linked to Michigan paper mill | CNN

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Health officials in Michigan said 109 cases of the rare fungal infection blastomycosis have been linked to a paper mill in Escanaba, an increase of five cases since the last update a week ago.