Blastomycosis, the disease caused by a fungus that has been detected in Michigan

The State of Michigan (United States) reported a death from blastomycosis recently. The victim was a paper mill workerThe site had to be closed for a thorough clean-up. Since March, at least 21 cases have been reported at the mill and dozens more are considered probable.

What is blastomycosis and why does it appear?

As stated in the diagnostic reference MSD Manual (more commonly known as the Merck Manual) in its version for the general public, blastomycosis is. an infection that primarily affects the lungs and is caused by the fungal species Blastomyces dermatitidis.

The spores of this fungus enter the organism by inhalation, through the respiratory tract. Sometimes, however, it can be spread to the bloodstream and reach other parts of the organism.such as the skin, prostate, epididymides, testes, seminal vesicles, kidneys, vertebrae, long bones, central nervous system, membranes of the mouth or nose, thyroid gland, lymph nodes or bone marrow.

Although it can occur in people with a normal immune system, it is more commonly the infection in immunosuppressed patientsin whom it also tends to become more severe. Most cases occur in North America, where the species is endemic. Rarely, it has also been reported in Africa and the Middle East.

What are its symptoms?

Blastomycosis can sometimes be totally asymptomatic or cause signs that disappear quickly and go unrecognized. When they do occur, they can appear gradually or abruptlyand include fever, chills, profuse sweating, chest pain, shortness of breath or persistent cough.

When spreads to other regions of the bodyit causes a wide range of signs depending on the organ affected. In the skin, it usually causes a series of lesions in the form of pus-filled papules, which develop into verrucous plaques surrounded by small abscesses.

How is it treated?

The treatment of blastomycosis primarily employs. antifungal drugsi.e. drugs that fight fungi. For example, amphotericin is usually chosen in severe cases and oral itraconazole in mild cases.

Usually the patient improves rapidly, but the treatments should be prolonged for at least six months (sometimes longer) to prevent the disease from starting again to slowly progress.