Blastomycosis

Blastomycosis General Information

Blastomycosis is a fungal infection of the human body. Caused by a fungus common in the United States (cases are being reported each year in Arkansas, Mississippi, Louisiana, Kentucky, Wisconsin), but also in Canada and parts of Central and South America and Africa, the infection of the human body is triggered by the inhalation of the fungus or its spores and although it typically affects the lungs, it can also extend to the skin, bones, brain or internal organs as the fungus spreads in the body through the bloodstream. The fungus responsible for the infection is the Blastomyces dermatitidisfungus, and the first records of the disease were the notes of Thomas Casper Gilchrist in 1894 – that is the reason why the infection is also commonly known as Gilchrist's disease.

While generally, the mortality rate for patients suffering of Blastomycosis is extremely low if the infection is diagnosed and treated in due time, as sometimes the infection may be asymptomatic, there have been recorded cases of death caused by large scale extension of the infection to multiple internal organs, causing severe damage to the tissues. Immuno-compromised patients may have a mortality rate of up to 29%, while patients also suffering from AIDS or from Acute Respiratory Distress Syndrome (ARDS) have much higher rate of mortality, between 40% and 70%.

As the fungus naturally inhabits a certain type of soil, it is recommended that woodworkers and farm workers are informed about the disease and its symptoms and that they undergo testing on a regular basis, in order to detect any signs of incipient infection. Campers and hunters are also advised to take the necessary precautions to prevent any kind of infection.

Blastomycosis Symptoms

As the infection is asymptomatic in 50% of the cases, it is highly recommended that a thorough screening is undergone whenever infection with Blastomyces dermatitidis is suspected. When present, Blastomycosis symptoms appear within 30-100 days from the date of exposure, and they are often flu like. The patient is likely to experience fever, chills and coughing, combined with myalgia and headache, which usually resolve within a few days from appearance. However, it has also been noted that the disease may take an acute form which is defined by high fever and chills, coupled with chest pains and productive coughing – much like the symptoms of bacterial pneumonia. In its chronic form, Blastomycosis will cause a weight loss in the patient, as well as night sweats, productive coughing and low fever.

However, there have been noted a sum of other symptoms as well as the infection extends to other parts of the body. The skin may present lesions which have small pustules at the outer rims; bone infection can be manifested as lytic lesions causing bone or joint pains. Prostate infection, although asymptomatic in most cases, can cause pain when urinating. As the infection spreads to the upper aerial tract, the infection may also cause hoarseness of voice. Blastomycosis has been noted sometimes to take the form of a fast paced severe disease, especially in patients already suffering from Acute Respiratory Distress Syndrome, and in such cases the patient will experience tachypnea, hypoxemia and shortness of breath, along with fever and diffuse pulmonary infiltrates. Such cases must be treated immediately, as they pose a very high risk to the patient’s life.

Blastomycosis Treatment

Once Blastomycosis is suspected, thorough testing must be undergone in order to establish if the person is infected with the fungus. Chest X-rays can be performed as the infection will present several abnormalities in the images; however they are not unique to the disease and can be caused by several other medical conditions. Also blood sampling and testing for the specific antibodies is possible, but may also prove to be inaccurate. A certain result will be obtained by performing a laboratory testing of a sputum or skin sample of the infected tissue, or by analyzing biopsy specimen cultures of the infected tissue. Skin testing and urine sampling testing are also available; however they may not be 100% accurate either. Once it has been established that the patient has been infected with the Blastomyces dermatitidis fungus, the health care specialist may prescribe one of the two antifungal medicines that typically employed in such situations and which have great results in curing Blastomycosis, namely Itraconazole and Fluconazole. Their curing rate is very high, and usually the patient will feel a relief of the symptoms shortly after starting the treatment. However, medication must be continued for several months in order to completely eradicate the fungus from the human body.

In severe cases of Blastomycosis, the mentioned drugs may not be sufficient to stop the infection. Immuno-compromised patients or patients in which the infection has affected the central nervous system are prescribed intravenous Amphotericin B. This is a more toxic drug and is the treatment of choice in such cases, as although it presents a higher risk to the patient, it also has a stronger effect in curing the infection. If you suspect that you are infected with the fungus or have been exposed to contamination, it is highly recommended that you contact your personal health care specialist for further testing in order for a diagnose to be set. Also, in cases where Blastomycosis has been confirmed, it is highly advised that you do not self-medicate. Instead, closely follow the treatment that you have been prescribed by your physician in order to completely recover from the infection. Although the symptoms may recede shortly after starting the treatment, it is advised that you continue medication for the entire period it was prescribed for, as the fungus needs to be completely eliminated from the system in order to ensure complete recovery. Untreated or mistreated infections will worsen over time and may lead to death of the patient.

While it has been documented that Blastomycosis can affect animals, such as dogs that inhale the spores from disturbing contaminated soil, the infection cannot be transmitted from one patient to another. However, the appearance of infections in humans or animals should serve as an indicator that the area is contaminated, and should pose a warning to the risks of exposure for the people in the area.