Blastomyces dermatitidis; Blastomycosis

Question 1

patient presentation

Answer 1

painful lesion on nose (verrucous lesion), major weight loss, pleuritic chest pain(right side), fever and productive cough, skin show verrucous lesions

increased neutrophils, lymphocytes and monocytes

X ray shows multiple nodular lesions; possible cavitation (formation of an empty space within a solid object or body) seen in 15-20%

Question 2

Lab culture

Answer 2

demonstrates dimorphism (yeast at 37/mold at 25);

yeast described as broad based budding

Question 3

treatment

Answer 3

oral intraconazole (>4 weeks pulmonary symptoms)

severe infection: amphotericin B

Question 4

Commonly acquired where?

Answer 4

Ohio Mississippi valley, central and southeast US, wooded vegetations