Presentation
Chronic pulmonary blastomycosis can present with a constellation of symptoms that may be indistinguishable from chronic pulmonary histoplasmosis, pulmonary tuberculosis, or lung cancer. [ncbi.nlm.nih.gov]
Clinical presentation There can be marked variation in presentation ranging from from asymptomatic infection to rapidly severe and fatal disease. [radiopaedia.org]
Underlying diseases that lead to immunodepression were present in only one patient and probable partial immunodepression was present in two other patients. Data from 19 other cases reported in the literature are discussed. [thedoctorsdoctor.com]
Other types of blastomycosis infections are known as: Acute pulmonary, which presents as a set of symptoms that mimics bacterial pneumonia; Chronic pulmonary, which mimics bronchogenic cancers; Skin disease, which presents skin lesions; Subcutaneous [medicalook.com]
These infections present a special challenge to physicians for several reasons, including of the recent disasters caused by severe acute respiratory syndrome (SARS) and bird and swine influenza, the increase in viral and bacterial resistance to currently [books.google.com]
Entire Body System
- Fever
A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL). [ncbi.nlm.nih.gov]
Symptoms of blastomycosis in the lung include cough, chest pain, weight loss, and a moderate fever. Skin ulcers may be reported. Bone or joint pain may be present, if the infection has spread to these areas. Physical exam confirms the fever. [nmihi.com]
Symptoms include high fever, chills, productive cough, and pleuritic chest pain. Sputum is purulent or mucopurulent. Blastomycosis: Clinical manifestations: Chronic pulmonary blastomycosis. [quizlet.com]
It may begin gradually with a flu-like illness with fever, chills, weakness, headache, and dry cough. [medicalook.com]
The symptoms and signs of acute pulmonary blastomycosis are fever, cough, and myalgias; a localized pulmonary infiltrate is seen on chest radiographs. [aibolita.com]
- Fatigue
A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL). [ncbi.nlm.nih.gov]
The symptoms include fever, night sweats, weight loss, fatigue, dyspnea, cough, sputum production, and hemoptysis. The chest radiograph shows upper lobe cavitary infiltrates, masslike lesions, or multiple nodular lesions (see Figure 40-4). [aibolita.com]
[…] develop slowly, can be mild or severe and can include [2,3] : Persistent dry cough or, rarely, coughing up yellow or green mucus or blood, chest pain during coughing Shortness of breath during exercise Low-grade fever, night sweets Anorexia, weight loss Fatigue [ehealthstar.com]
Fatigue, loss of apetite. If skin involved, may have lesions or abscesses. Causes Infection with the fungus, Blastomyces dermatitidis, found in wood and soil. There may be some association with beaver huts. [nmihi.com]
Symptoms include high fever, chills, cough, fatigue, shortness of breath, night sweats and sputum production. -A small percentage of these patients develop nodules or cavities in the lungs. [quizlet.com]
- Malaise
The initial clinical presentation of blastomycosis includes fever, malaise, weight loss, cough and pleuritic chest pain. Cutanous lesions and less commonly bone, genitourinary and central nervous system involvement can occur. [ped-rheum.biomedcentral.com]
Other symptoms of blastomycosis may include a cough that produces brown or bloody mucus, shortness of breath, sweating, fever, fatigue, malaise, weight loss, joint stiffness and pain, muscle stiffness and pain, pain suring urination, a rash that may include [medicalook.com]
Acute Blastomycosis Blastomycosis typically presents as a flulike illness characterized by fever, malaise, fatigue, weight loss, and pulmonary involvement. [hivinsite.ucsf.edu]
Symptoms include cough, purulent sputum, hemoptysis, fever, malaise, and weight loss. Chest radiographs can show mass-like lesions, upper lobe cavitary infiltrates, or scattered nodules. [infectiousdiseaseadvisor.com]
Symptomatic infection is associated with cough, chest pain, fevers, malaise, sputum production, and hemoptysis. [clinicaladvisor.com]
- High Fever
Symptoms include high fever, chills, productive cough, and pleuritic chest pain. Sputum is purulent or mucopurulent. Blastomycosis: Clinical manifestations: Chronic pulmonary blastomycosis. [quizlet.com]
In later stages it may be nearly impossible to tell it from bacterial pneumonia or even tuberculosis because of the sputum, high fever, night sweats, and chest pain involved. [medicalook.com]
[…] infectious adult respiratory distress syndrome (ARDS) with high fever, diffuse infiltrates, and progressive respiratory failure. [thedoctorsdoctor.com]
In rare cases, when exposure to the organism is extensive or the host is immunosuppressed, acute overwhelming pneumonia, characterized by high fevers, hypoxemia, and diffuse retic-ulonodular infiltrates, is seen. [what-when-how.com]
Respiratoric
- Cough
Symptoms Fevers for more than a week Cough for more than three weeks Swollen lymph nodes (glands) in your neck Coughing up blood Feeling like your symptoms return every time you stop antibiotics Types of Chronic Pulmonary Infections Tuberculosis Spread [lungcenter.osu.edu]
A 21-year-old previously healthy woman presented with a three-week history of shortness of breath and dry cough. She had recently returned from a humanitarian trip planting crops in El Salvador. [ncbi.nlm.nih.gov]
Symptoms include high fever, chills, productive cough, and pleuritic chest pain. Sputum is purulent or mucopurulent. Blastomycosis: Clinical manifestations: Chronic pulmonary blastomycosis. [quizlet.com]
[…] or, rarely, coughing up yellow or green mucus or blood, chest pain during coughing Shortness of breath during exercise Low-grade fever, night sweets Anorexia, weight loss Fatigue Swollen lymph nodes in the chest, neck and armpits Skin rash Diagnosis [ehealthstar.com]
Most patients diagnosed with pulmonary blastomycosis have chronic indolent pneumonia with signs and symptoms of fever, weight loss, productive cough, and hemoptysis. [encyclopedia.lubopitko-bg.com]
- Sputum
I discovered that sputum containing this organisms had white clumps and strings that contained yeast cells. [nutramed.com]
Sputum is purulent or mucopurulent and hemoptysis may be present. Blastomycosis: Clinical manifestations: Disseminated blastomycosis. [quizlet.com]
The organism was cultured from the patient's sputum when the lymph node was enlarged. Serologic studies for blastomycosis were negative both in the patient and in his co-workers who were similarly exposed to this culture. [annals.org]
Cough, either dry and non-productive or with sputum. Chest pain. Chills, fever and drenching sweats. Shortness of breath. Fatigue, loss of apetite. If skin involved, may have lesions or abscesses. [nmihi.com]
Once in the lab the samples of sputum and skin or tissue biopsy are put through many more tests. [austincc.edu]
- Pleural Effusion
Lymphadenopathy and pleural effusions may be uncommonly present. Promoted articles (advertising) [radiopaedia.org]
Joint aspiration if joint effusion. [patient.info]
Pleural effusions and hilar adenopathy are uncommon. Most patients diagnosed with pulmonary blastomycosis have chronic indolent pneumonia with signs and symptoms of fever, weight loss, productive cough, and hemoptysis. [encyclopedia.lubopitko-bg.com]
Pleural effusion occurs occasionally. Some patients have rapidly progressive infections, and acute respiratory distress syndrome may develop. In extrapulmonary disseminated blastomycosis, symptoms depend on the organ involved. [merckmanuals.com]
CT scans can show tree-in-bud opacities, pleural effusions, nodular lesions, or consolidation occasionally with cavitation. [clinicaladvisor.com]
- Productive Cough
It usually presents as a flu -like illness with fever, chills, productive cough, myalgia, arthralgia and pleuritic chest pain. [medicinenet.com]
Symptoms include high fever, chills, productive cough, and pleuritic chest pain. Sputum is purulent or mucopurulent. Blastomycosis: Clinical manifestations: Chronic pulmonary blastomycosis. [quizlet.com]
Most patients diagnosed with pulmonary blastomycosis have chronic indolent pneumonia with signs and symptoms of fever, weight loss, productive cough, and hemoptysis. [encyclopedia.lubopitko-bg.com]
Symptomatic infection is associated with cough, chest pain, fevers, malaise, sputum production, and hemoptysis. [clinicaladvisor.com]
Chronic pulmonary disease is characterized by productive cough, hemoptysis, weight loss, and pleuritic chest pain, with variable radiologic findings. [hopkinsarthritis.org]
- Chronic Cough
We report the case of a Tunisian patient aged 35 years with no previous medical history, hospitalized with chronic cough, bilateral basithoracic pain, fever and weight loss. [scienceopen.com]
Chronic pulmonary disease is characterized by productive cough, hemoptysis, weight loss, and pleuritic chest pain, with variable radiologic findings. [hopkinsarthritis.org]
[…] aspergilloma (especially after Tb infection): chronic cough, hemoptysis Invasive aspergillosis : fever, cough, respiratory distress Endocarditis ABPA : eosinophilia, ↑ IgE, pulmonary infiltrates on chest x-ray or CT Pulmonary aspergilloma : x-ray or [amboss.com]
Workup
DIAGNOSIS PULMONARY INFECTION: • Tuberculosis • Bronchogenic carcinoma • Histoplasmosis • Bacterial pneumonia CUTANEOUS INFECTION: • Bromoderma • Pyoderma gangrenosum • Mycobacterium marinum infection • Squamous cell carcinoma • Giant keratoacanthoma WORKUP [encyclopedia.lubopitko-bg.com]
We have reviewed the utilization of diagnostic techniques in the workup of patients with pulmonary blastomycosis, defined their diagnostic yields, and proposed an optimal diagnostic approach for the patient in whom pulmonary blastomycosis is considered [thedoctorsdoctor.com]
X-Ray
- Pulmonary Infiltrate
The symptoms and signs of acute pulmonary blastomycosis are fever, cough, and myalgias; a localized pulmonary infiltrate is seen on chest radiographs. [aibolita.com]
Diffuse pulmonary infiltrates were seen on a chest radiograph ( Figure 1A ). A pulmonary-artery catheter was inserted and revealed a pulmonary-artery occlusive pressure of 10 mm Hg. [nejm.org]
CXR: May show patchy infiltration, nodules, consolidation, cavitation or pleural effusion. Pronounced mediastinal lymphadenopathy - some endemic fungal pneumonias. Miliary-pattern pulmonary infiltration in extensive disease. [patient.info]
Clinical presentations Pulmonary Blastomycosis Blastomycosis begins as a pulmonary infection, but many patients never develop symptoms, and others have an acute illness with fever, cough, and a pulmonary infiltrate that is diagnosed as an atypical pneumonia [what-when-how.com]
Other symptoms include pulmonary infiltrates, bone lesions, skin lesions, and a rash (ulcerative) (8). [austincc.edu]
Pleura
- Pleural Effusion
Lymphadenopathy and pleural effusions may be uncommonly present. Promoted articles (advertising) [radiopaedia.org]
Joint aspiration if joint effusion. [patient.info]
Pleural effusions and hilar adenopathy are uncommon. Most patients diagnosed with pulmonary blastomycosis have chronic indolent pneumonia with signs and symptoms of fever, weight loss, productive cough, and hemoptysis. [encyclopedia.lubopitko-bg.com]
Pleural effusion occurs occasionally. Some patients have rapidly progressive infections, and acute respiratory distress syndrome may develop. In extrapulmonary disseminated blastomycosis, symptoms depend on the organ involved. [merckmanuals.com]
CT scans can show tree-in-bud opacities, pleural effusions, nodular lesions, or consolidation occasionally with cavitation. [clinicaladvisor.com]
Treatment
Reference is easy thanks to a unique 3-part structure covering general aspects of treatment; reviews of every agent; and details of treatments of particular infections. [books.google.de]
Treatment of cytomegalovirus pneumonia with ganciclovir and intravenous cytomegalovirus immunoglobulin in patients with bone marrow transplants. [books.google.com]
Efficacy of voriconazole in treatment of murine pulmonary blastomycosis.. Antimicrob Agents Chemother 45 :, 601– – 604. [jmm.microbiologyresearch.org]
BLASTOMYCOSIS TREATMENT If it is determined that you do indeed have blastomycosis, it is possible that your infection my resolve itself without treatment, especially if the infection remains within the lungs, but doctors recommend that you begin treatment [medicalook.com]
Predicted outcome The prognosis is good if treatment is begun early. Most infections will resolve with treatment. Advanced bone disease or, rarely, brain involvement will lengthen disability and chance of complete recovery. [nmihi.com]
Prognosis
Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.com]
IDSA clinical practice guidelines 2008 Outlook and prognosis In non-immunocompromised patients cure rates of 95% are typical. Outcomes are good even in very ill patients, if the diagnosis is made early and amphotericin B therapy initiated. [life-worldwide.org]
Predicted outcome The prognosis is good if treatment is begun early. Most infections will resolve with treatment. Advanced bone disease or, rarely, brain involvement will lengthen disability and chance of complete recovery. [nmihi.com]
The prognosis for chronic cutaneous blastomycosis is considerably better than that for systemic disease. Mitchell, T. Blastomycosis, in Feigin and Cherry, eds. Pediatric Infectious Disease, p. 1927. Chessney, J. Pulmonary blastomycosis in children. [mold-help.org]
Therapy must be individualized and must be given for life.49 Prognosis Of all the endemic mycoses, infection with C. immitis is the least responsive to currently available antifungal agents. [what-when-how.com]
Etiology
In spite of diligent investigations by many competent investigators, we still do not know the ecological niche inhabited by the etiologic agent. We have many tantalizing clues but no definite answers. [books.google.com]
Due to the infrequent isolation in nature of the organism the etiological niche and virulence factors are uncertain (5) (8). The fungus Blastomyces dermatitides once inhaled will attach to the lungs causing pulmonary lesions. [austincc.edu]
Etiology Pathogen Aspergillus, a genus including over 200 species Most common: Aspergillus fumigatus, Aspergillus flavus Transmission : airborne exposure to mold spores Risk factors Destructive pulmonary pathology → Chronic pulmonary aspergillosis Severe [amboss.com]
Epidemiology
Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.com]
Adapted from: Wisconsin Epidemiology Bulletin 1995;16(no. 2). Bur of Public Health, Div of Health, Wisconsin Dept of Health and Social Svcs. [cdc.gov]
Discussion In this report we update the epidemiology of blastomycosis hospitalizations in the United States. [journals.plos.org]
Pathophysiology
Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.com]
We describe the clinical and pathophysiologic findings in our 10 patients, including the results of long-term follow-up with pulmonary-function testing in 3 of the survivors, review the previously reported cases, and suggest an approach to the diagnosis [nejm.org]
Prevention
Centers for Disease Control and Prevention (June 12, 2015 updated.) Candidiasis. Available online at http://www.cdc.gov/fungal/diseases/candidiasis/index.html. Accessed August 27, 2016. [labtestsonline.it]
Prevention of bacterial endocarditis. الصفحة 303 - American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. [books.google.com]
Get optimal test results with guidance on error detection, correction, and prevention as well as cost-effective test selection. [books.google.de]