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Blastomycosis - Causes and Symptoms
Other Names: North American blastomycosis; Gilchrist's disease.
Definition of Blastomycosis:
Blastomycosis is an infection caused by inhaling microscopic particles (spores) produced by the fungus Blastomyces dermatitidis. It is usually characterized by multiple inflammatory lesions of the skin, mucous membranes, or internal organs.
Blastomycosis may be limited to the lungs or also involve the skin and bones. In its most severe form, the infection can spread throughout the body and involve many organ systems (systemic). It is mainly found in North America and is endemic to the southeastern United States. Sporadic cases have also been reported in Africa. Blastomycosis usually infects men ages 30 to 50, but no occupational link has been found.
Causes of Blastomycosis
Blastomycosis is mainly caused by a fungus, blastomyces dermatitidis - found mainly in wood and soil. Skin lesions occur most commonly in gardeners, farmers, or some association with beaver huts, but the natural source of this fungus is unknown. The fungus grows on Sabouraud agar at room temperature (250°C) as a white fluffy mold. Alternatively, at body temperature (37°C) and on blood agar, the fungus forms a brown wrinkled colony.
Blastomycosis is not a contagious disease and cannot be transferred from one person to other. Inhalation of the microconidia from the mold form of B dermatitidis into the lungs can also lead to blastomycosis infection. Once inhaled, the spores of B. dermatitidis can lodge in the lungs and cause a localized inflammation. This is known as primary pulmonary blastomycosis.
Symptoms of Blastomycosis
Blastomycosis is usually more common among men than women. In approximately 25% of blastomycosis cases, only the lungs are affected. Lung infection may produce no symptoms, but when the infection is widespread, skin lesions or bone lesions may appear and the urogenital system (bladder, kidney, prostate, testes) may be affected.
When blastomycosis spreads, it can affect many areas of the body, but the skin, bones, and genitourinary tract are the most common sites. A skin infection begins as very small, raised bumps (papules), which may contain pus.
In the early stages, symptoms may include:
- dry cough
- fever
- heavy sweating
- fatigue
- a general feeling of ill health.
In severe cases:
- Cough ( accompanied with sputum which may be brown or bloody).
- Shortness of breath.
- Fatigue.
- Sometimes sudden blindness may be there.
- General discomfort, uneasiness, or ill-feeling ( malaise ).
- Fever of 104 degrees or higher.
- Unintentional weight loss.
- Joint stiffness and joint pain.
- Lethargy.
- Abscess of the skin.
- There may be blood in the urine.
- Muscular stiffness and pain.
- Loss of appetite.
- Rash or Skin lesions may also develop.
- Chest pain.
- Intolerance for activity.
Treatment for Blastomycosis
All immunocompromised patients with progressive pulmonary infection should be treated. Spontaneous cure has been well documented for patients with acute pulmonary infection. Thus, in selected cases, patients may be closely monitored for resolution or progression of disease.
The primary goal of treatment is to control the infection. The best treatment has been amphotericin B. Sulfonamide drugs have been used and proved to be very effective in controlling the infection, although they don't kill the fungus.
Though not all blastomycosis infection in the lungs requires antibiotics, but, when the disease has spread outside of the lungs then antibiotics are very much essential. Scientists are studying new treatments for the fungal infection, including ketoconazole, fluconazole, and itraconazole, which appear to be equally effective as amphotericin B, according to research.
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