Pulmonary blastomycosis: a new endemic area in<scp>N</scp>ew<scp>Y</scp>ork state

Permpalung, Nitipong; Kaewpoowat, Quanhathai; Prasidthrathsint, Kunatum; Chongnarungsin, Daych; Hyman, Charles

doi:10.1111/myc.12073

Cited by 13 publications

(12 citation statements)

References 9 publications

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“…Unlike the similar fungal diseases coccidioidomycosis and histoplasmosis, a skin test has not been available to assess geographic distribution of exposure. Data regarding blastomycosis in New York are limited, with reports of canine infections suggesting endemicity along the Saint Lawrence River on the New York-Canada border ( 2 ). Outdoor exposures and proximity to waterways have been associated with the disease; however, little about its ecology and epidemiology is known.…”

mentioning

confidence: 99%

Notes from the Field:Blastomycosis Cases Occurring Outside of Regions with Known Endemicity — New York, 2007–2017

McDonald¹,

Dufort²,

Jackson³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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mentioning

confidence: 99%

Notes from the Field:Blastomycosis Cases Occurring Outside of Regions with Known Endemicity — New York, 2007–2017

McDonald¹,

Dufort²,

Jackson³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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“…6 Blastomyces dermatitidis has been considered endemic to NYS within a narrow strip along the St Lawrence River, where cases of canine blastomycosis have been previously reported. 5,7 Cases of human blastomycosis were reported in NYS for the first time by Permpalung et al 5 in 2013. These cases occurred outside the previously identified endemic region and 75 miles west of our patient's area of residence in the Mohawk Hudson River Valley.…”

Section: Case Reportmentioning

confidence: 97%

“…7 The lungs are the primary route of infection due to inhalation of conidia from disrupted soil, and the spectrum of disease ranges from subclinical infections to potentially fatal systemic dissemination. [1][2][3][4][5][6]8 Single organ infections with B. dermatitidis have been demonstrated in 69% to 80% of cases, most commonly in the lungs. 1 Extrapulmonary dissemination occurs through hematogenous spread and most commonly includes the skin, bone, and genitourinary system.…”

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confidence: 99%

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Central Nervous System Blastomycosis Without Travel to Known Endemic Area

Spallone¹,

Tobin

Chaturvedi

et al. 2016

Infect Dis Clin Pract

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Blastomycosis is thought to be endemic to specific regions of the United States. The spectrum of disease ranges from subclinical infections to potentially fatal systemic dissemination. Single organ involvement often involves the lungs. Extrapulmonary dissemination often includes the skin, bone, and genitourinary systems. There are rare reports of isolated central nervous system blastomycosis. Herein, we report a case of isolated central nervous system infection in a patient residing in New York State without travel to known endemic regions. Diagnosis was established as Blastomyces dermatitidis by morphologic characteristics of biopsied tissue and was confirmed through real-time polymerase chain reaction assays. In addition, the culture was confirmed as B. dermatitidis by conventional and real-time polymerase chain reaction assay. The patient was treated with prolonged antifungal therapy and is clinically well. This report suggests an expansion of the endemic geography of blastomycosis and highlights the utility of molecular methods for diagnosis.

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“…Data regarding the benefit of this practice remain anecdotal. 59,[105][106][107][108] It is likely that no clinical trials will be done to prove the efficacy of corticosteroids because of the rarity of this complication. 59 We favor the use of corticosteroids as an adjunct to lipid formulation amphotericin B for patients with this lifethreatening complication and suggest a dose of 1 mg/kg methylprednisolone daily for 7 to 10 days.…”

Section: Difficult-to-treat Complications Of Blastomycosismentioning

confidence: 99%

Blastomycosis

Schwartz

Kauffman

2020

Semin Respir Crit Care Med

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Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic fungi belonging to the genus Blastomyces. The genetic and geographic diversity of these pathogens is greater than previously appreciated. In addition to Blastomyces dermatitidis and the cryptic species Blastomyces gilchristii, which cause blastomycosis in mid-western and various eastern areas of North America, atypical blastomycosis is occasionally caused by Blastomyces helicus in western parts of North America and Blastomyces percursus in Africa. Blastomycosis is acquired by inhalation of the conidia that are produced in the mold phase; in the lungs, temperature-dependent transformation occurs to the yeast phase. In this form, the organism is phagocytized by macrophages and can spread hematogenously to various organs causing disseminated infection. Pulmonary disease is most common and varies from mild, self-limited infection to severe, potentially fatal adult respiratory distress syndrome. Disseminated infection is manifested primarily by skin lesions, but many other organs can be involved. Diagnosis is established by growth of the organism in culture; however, a tentative diagnosis can be made quickly by histopathological identification of the classic yeast form in tissues or by finding Blastomyces antigen in urine or serum. Blastomycosis is treated initially with amphotericin B when the disease is severe, involves the central nervous system, or the host is immunosuppressed. Itraconazole is recommended for primary therapy in mild-to-moderate infection and for step-down therapy after initial amphotericin B treatment. Voriconazole and posaconazole can be used for patients in whom itraconazole is not tolerated.

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Pulmonary blastomycosis: a new endemic area inNewYork state

Cited by 13 publications

References 9 publications

Notes from the Field:Blastomycosis Cases Occurring Outside of Regions with Known Endemicity — New York, 2007–2017

Notes from the Field:Blastomycosis Cases Occurring Outside of Regions with Known Endemicity — New York, 2007–2017

Central Nervous System Blastomycosis Without Travel to Known Endemic Area

Blastomycosis

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