What is Blastomycosis & How is it Treated?

Blastomycosis is a fungal infection caused by the genotype of the fungus Blastomyces Dermatitidis. It is also known by the name of North American Blastomycosis and Gilchrist’s disease and is known to occur mostly in the central and southeastern part of the United States. Some cases of Blastomycosis have also been known top occur in some parts of Canada and Africa. These fungi not only infect human being but may also affect various animals like horses and cats. Lung is the organ which is affected the most by Blastomycosis.

Blastomycosis is caused when the spores of the offending fungus Blastomyces Dermatitidis become airborne and inhaled by an individual. Although most of the fungus is killed when they enter the lungs by specialized cells present in the lungs, there are some spores which take the form of yeast like infection and are not able to be destroyed by these cells. This happens basically because of the body temperature which changes the form of spores from fungal to yeast. These yeasts then start to multiply and spread to other organs and parts of the body through the blood resulting in Blastomycosis.

Around half of the cases of Blastomycosis are asymptomatic. The condition usually becomes symptomatic after about a couple of weeks of incubation time after the initial exposure. The initial symptoms of Blastomycosis are similar to that of a common influenza and include fever, chills, cough, and muscle and joint pains. Once the infection is spread to other parts and skin then there may be development of skin lesions.

The diagnosis of Blastomycosis begins with a detailed history taking to identify any presumptive exposure to the offending fungus. Microscopic testing of scrapings from the skin and other infected tissues can also help in the diagnosis of Blastomycosis which can clearly identify the fungus responsible for this condition. The most definitive way of diagnosing Blastomycosis is by the isolation technique of the fungus from tissue samples and allowing it to grow. Testing the urine and blood may also confirmatively diagnose Blastomycosis.

Use of antifungals is the best way to treat Blastomycosis. The drug most preferred to treat this condition is called itraconazole also known as Sporanox. This medication is quite effective and potent in treating mild to moderate cases of Blastomycosis. Amphotericin B. is the preferred medication to treat severe cases of Blastomycosis. A combination of amphotericin B and itraconazole can be used in the elderly population with compromised immune system with severe cases of Blastomycosis.

The duration of treatment of Blastomycosis is for a minimum of six months up to a year. In some cases where the patient is extremely immune compromised then the treatment may go on lifelong. This is usually in the elderly population or in patients with other illnesses which severely compromise the immune system of the patient. Additionally, newer antifungals are being investigated for treatment for Blastomycosis.

The prognosis for Blastomycosis is quite variable, as about half of the cases of Blastomycosis do not cause any symptoms and even if symptoms are experienced they are generally mild and resemble other common illnesses. In case if Blastomycosis is diagnosed and is treated appropriately and on time then the prognosis is quite good even though the treatment is quite prolonged and may continue for as long as a year. The prognosis becomes more guarded in patients with a weak immune system. The prognosis is quite poor in patients suffering from HIV/AIDS from Blastomycosis.

The prevention of Blastomycosis is quite difficult as the fungus is quite widespread, especially in the central and southeastern parts of the United States. The CDC has therefore advised people with immune compromised state to avoid visiting thickly wooded areas in these parts of the country as this is where the fungi thrives in. As of yet, there are no vaccines available to prevent an individual from Blastomycosis.

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