Blastomycosis

A fungal infection that may appear in two forms: 1, a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2, chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung.

Also Known As:

Gilchrist Disease; Gilchrist's Disease; Blastomycoses; Gilchrists Disease; North American Blastomycosis; Blastomycosis, North American

Networked: 510 relevant articles (66 outcomes, 42 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Histoplasmosis
2.	Coccidioidomycosis
3.	Infections
4.	Sporotrichosis
5.	Cryptococcosis

Experts

1.	Hage, Chadi A: 10 articles (08/2020 - 01/2007)
2.	Wheat, L Joseph: 9 articles (03/2019 - 11/2006)
3.	Kauffman, Carol A: 7 articles (12/2020 - 06/2008)
4.	Klein, Bruce S: 6 articles (01/2019 - 06/2002)
5.	Scalarone, G M: 6 articles (09/2005 - 01/2002)
6.	Wüthrich, Marcel: 5 articles (01/2016 - 06/2002)
7.	Klein, B S: 5 articles (12/2007 - 02/2000)
8.	Scalarone, Gene M: 4 articles (10/2019 - 07/2006)
9.	Davis, Thomas E: 4 articles (03/2019 - 01/2007)
10.	Durkin, Michelle M: 4 articles (03/2019 - 03/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Blastomycosis:

1.	Ketoconazole (Nizoral)FDA LinkGeneric 01/15/1983 - "Four dogs with blastomycosis were treated with ketoconazole, and good results were obtained in 3 of the 4 cases. " 01/15/1983 - "The results of the study suggested that ketoconazole is effective for the treatment of canine blastomycosis." 09/01/1997 - "Ketoconazole was shown to be effective for less than overwhelming blastomycosis, but adverse effects were relatively common. " 12/01/1994 - "Treatment of isolated laryngeal blastomycosis with ketoconazole. " 06/01/1990 - "Successful treatment of systemic blastomycosis with high-dose ketoconazole in a renal transplant recipient."
2.	Itraconazole (Sporanox)FDA LinkGeneric 05/01/2023 - "Itraconazole is the recommended first-line treatment for mild-to-moderate blastomycosis and consolidation treatment of moderate-to-severe disease. " 05/01/2023 - "This study supports an itraconazole therapeutic target combining itraconazole and hydroxy-itraconazole >1.0 mcg/ml for blastomycosis treatment." 05/01/2023 - "Defining target itraconazole and hydroxy-itraconazole serum concentrations for blastomycosis." 01/14/2023 - "With mild to moderate pulmonary or disseminated blastomycosis, oral itraconazole treatment is recommended." 11/01/2018 - "Pediatric primary cutaneous blastomycosis clinically responsive to itraconazole."
3.	Amphotericin B (Amphotericin)FDA LinkGeneric 03/01/2008 - "The patient was treated successfully with amphotericin for blastomycosis of the eye, lung, and thyroid. " 04/01/1967 - "[Multivisceral blastomycosis with pulmonary predominance in a Frenchman of Tunisian origin cured by amphotericin B]." 12/01/2022 - "Radical treatment for blastomycosis following unsuccessful liposomal amphotericin." 01/09/2022 - "The patient was started on amphotericin B 5 mg/kg every 24 h for severe blastomycosis. " 01/01/2020 - "Blastomycosis is treated initially with amphotericin B when the disease is severe, involves the central nervous system, or the host is immunosuppressed. "
4.	AntigensIBA 03/01/2014 - "Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis." 02/01/1981 - "Seven of 10 patients with proved blastomycosis had positive results on DID assays for antibody to the A antigen of Blastomyces dermatitidis. " 11/01/2019 - "Given the paucity of Blastomyces-positive samples, further studies are needed to better compare the utility of the MVista and ND Histoplasma urine antigen assays in diagnosing blastomycosis." 10/01/2019 - "Recent studies have focused on the utilization of antibody and antigen detection in the development of immunoassays for the diagnosis of blastomycosis. " 01/01/2013 - "The aim of this study was to evaluate the diagnostic sensitivity of Blastomyces dermatitidis yeast lysate antigens with respect to antibody detection in dogs with blastomycosis. "
5.	liposomal amphotericin B FDA Link 12/01/2022 - "He improved significantly and was decannulated from ECMO on day 9 of AmBd continuous infusion and extubated on day 12 Although L-AmB is considered first-line treatment for blastomycosis, mortality remains high for patients with ARDS associated with blastomycosis. " 12/15/1996 - "Amphotericin B lipid complex was a safe and effective treatment for blastomycosis in these dogs." 12/01/2022 - "This case highlights the importance of considering AmB-d continuous infusions for patients with severe blastomycosis who might have poor clinical responses to L-AmB." 12/01/2022 - "In this Grand Round, we present the case of an immunocompetent 35-year-old man diagnosed with chronic pulmonary blastomycosis who had a poor response to 10 days of intravenous liposomal amphotericin B (L-AmB). " 11/01/2020 - "Keywords pulmonary blastomycosis pregnancy biopsy computed tomography angiography liposomal amphotericin B."
6.	Fluconazole (Zonal)FDA LinkGeneric 02/01/1995 - "We conclude that fluconazole (200 mg to 400 mg daily) given for at least 6 months is moderately effective treatment for blastomycosis." 05/01/2011 - "Fluconazole is associated with survival to clinical remission in 75% of dogs with blastomycosis. " 02/01/1995 - "We conducted a multicenter, randomized, open-label pilot trial comparing two daily doses of fluconazole (200 mg and 400 mg) in the treatment of non-life-threatening, non-CNS blastomycosis. " 01/01/2020 - "Disseminated Blastomycosis Presenting as Obstructive Renal Mass Treated With Fluconazole." 06/01/2017 - "He was diagnosed with pulmonary blastomycosis by histological examination of lung biopsy and treated with fluconazole. "
7.	Voriconazole (Vfend)FDA LinkGeneric 02/01/2001 - "Efficacy of voriconazole in treatment of murine pulmonary blastomycosis." 10/01/2009 - "Further studies are needed to fully elucidate the role of voriconazole in the treatment of CNS blastomycosis. " 10/01/2009 - "To date, no clinical trials have evaluated the use of voriconazole in treating CNS blastomycosis. " 08/01/2022 - "A 68-year-old man with biopsy-proven eyelid blastomycosis was treated with 6 months of oral voriconazole, but resolution of the lesion was complicated by cicatricial changes causing complete lower eyelid defect, epicanthal web, cicatricial mechanical ptosis, and skin plaques. " 10/01/2009 - "Search terms included voriconazole, blastomyces, blastomycosis, CNS, cerebral, and central nervous system. "
8.	Adrenal Cortex Hormones (Corticosteroids)IBA 05/01/2016 - "Bootstrap studies indicated that almost 500 patients would be needed to confirm a significant reduction in mortality from corticosteroids (type I error = 0.05, power = 80%).Blastomycosis is an uncommon, albeit important, cause of ARDS in this geographic area. " 06/01/2008 - "We suggest that treatment with corticosteroids may be of benefit in patients with blastomycosis-induced ARDS. " 06/01/2008 - "Corticosteroids for blastomycosis-induced ARDS: a report of two patients and review of the literature." 09/01/2007 - "The administration of systemic corticosteroids did not appear to adversely affect the survival rate and might have played a role in preservation of vision in a majority of dogs in this group with ocular blastomycosis." 09/01/2007 - "To evaluate the success of the use of systemic corticosteroids and antifungal medications in the treatment of dogs with ocular lesions associated with systemic blastomycosis. "
9.	EnzymesIBA 02/01/2014 - "Earlier studies have shown that the enzyme immunoassay improves the sensitivity of antibody detection for the diagnosis of blastomycosis. " 05/01/2012 - "Cross-reactivity in the Platelia™ Aspergillus enzyme immunoassay caused by blastomycosis." 03/01/1995 - "Thirteen of the 65 sera from suspected blastomycosis cases were positive by the enzyme immunoassay only, whereas none reacted positively in the micro-immunodiffusion test. " 03/01/1995 - "One hundred and three sera drawn from 20 proven and 65 suspected cases of blastomycosis were examined concurrently with the enzymes immunoassay and microimmunodiffusion tests for the 'A' antibody specific for Blastomyces dermatitidis. " 07/01/1990 - "Comparison of enzyme immunoassay and immunodiffusion for the detection of canine blastomycosis."
10.	TriazolesIBA 07/01/2022 - "Antifungal susceptibility testing showed a consistently low minimum inhibitory concentration to ISA ≤ 0.015 mcg/mL. This case series supports the efficacy and safety for ISA in the treatment of blastomycosis with or without CNS disseminated, especially when alternative triazoles cannot be used." 07/01/2022 - "Isavuconazonium sulphate (ISA) is a triazole with in vitro and in vivo activity against Blastomyces spp, but there is a paucity of clinical data supporting its use for treatment of blastomycosis. " 02/01/2001 - "We evaluated the efficacy of voriconazole, a new broad-spectrum triazole antifungal compound, in the treatment of murine pulmonary blastomycosis. " 10/01/2009 - "Voriconazole is a broad-spectrum triazole antifungal that has emerged as a potential treatment option for CNS blastomycosis because of its excellent penetration into the cerebrospinal fluid and brain tissue. " 07/01/1995 - "Itraconazole is a triazole compound with broad-spectrum antifungal activity which includes the pathogenic yeasts, certain Aspergillus species, and the endemic fungi such as Histoplasma capsulatum and Blastomycosis dermatitidis. "

Therapies and Procedures

1.	Therapeutics 10/07/2005 - "Consistent with the in vitro enhancement of effector cell function by IFN-gamma, in vivo therapy with IFN-gamma significantly (P<0.0001) improved survival of BALB/c mice with pulmonary blastomycosis." 10/01/1985 - "In bronchoalveolar lavage fluid, pulmonary blastomycosis patients who were clinically improved while receiving antifungal therapy had fewer TH cells and a greater number of lymphocytes with the TS marker than did control subjects. " 02/01/1998 - "Of the other 3 patients, 1 is still receiving therapy and is probably cured, 1 died of blastomycosis, and the status of 1 is unknown. " 01/01/1987 - "This quantitative, reproducible model of chronic murine blastomycosis mimics the human disease in many respects and should provide a basis for future studies of the immunology, pathogenesis, and therapy of chronic blastomycosis." 12/01/1983 - "Detailed pulmonary function studies were performed on 2 patients with diffuse pulmonary North American blastomycosis before and after therapy. "
2.	Aftercare (After-Treatment) 03/01/2014 - "21 dogs with newly diagnosed blastomycosis monitored until clinical remission (Treatment Phase), and 27 dogs monitored over 1 year from the time of antifungal discontinuation or until clinical relapse (After Treatment Phase). " 04/01/2006 - "We report a case of central nervous system blastomycosis occurring 18 months after treatment of pulmonary blastomycosis in an immunocompetent child. " 01/01/2002 - "CT is therefore recommended as a screening test for intracranial blastomycosis in dogs and also as an imaging modality for follow-up evaluation after treatment. " 05/01/2000 - "For 93 serial serum samples from 29 dogs with blastomycosis, the mean anti-WI-1 titer was 1:18,761 at the time of diagnosis, and decreased to a mean of 1:1,338 by 210 days after treatment was initiated. " 12/15/1996 - "One dog died of an unrelated cause 5.5 months after treatment, but did not have clinical signs of blastomycosis at the time of death. "
3.	Thoracotomy 09/01/1996 - "Dissemination of pulmonary blastomycosis after thoracotomy." 03/01/1992 - "The diagnosis of pulmonary blastomycosis was made at thoracotomy. " 04/01/1991 - "If these risk factors are kept in mind, the diagnosis of blastomycosis may be established before a thoracotomy is performed unnecessarily." 03/01/1981 - "In five cases of blastomycosis, invasive procedures were required before the diagnosis was established; these included thoracotomy in two cases and craniotomy in a third case. " 08/01/1977 - "Since cytologic techniques are simple, readily available, and rapid, they can be helpful in differentiating pulmonary neoplasms from pulmonary blastomycosis, thus reducing the need for diagnostic thoracotomies."
4.	Artificial Respiration (Mechanical Ventilation) 01/01/2021 - "Outcomes of patients with severe pulmonary blastomycosis requiring mechanical ventilation (MV) are not well understood in the modern era. " 06/01/1995 - "She developed disseminated blastomycosis, adult respiratory distress syndrome (ARDS), and ulcerative skin lesions, requiring mechanical ventilation, amphotericin B, and multiple surgeries. " 06/18/2023 - "We describe a case report of a patient with Blastomycosis-induced acute respiratory distress syndrome (ARDS) and severe hypoxemia requiring mechanical ventilation, prone positioning, and neuromuscular blockade whose clinical condition rapidly improved with the use of corticosteroids resulting in the patient being discharged home without the need for supplemental oxygen."
5.	Salvage Therapy 04/01/2012 - "However, 15 weeks after the onset of salvage therapy, he succumbed to polymicrobial sepsis despite treatment with prophylactic anti-infectives, with necropsy revealing disseminated blastomycosis and relapsed HLH. " 04/01/2009 - "In a retrospective review of 24 patients with histoplasmosis, blastomycosis, or coccidioidomycosis treated with voriconazole (most for salvage therapy), the outcome was favorable (improved or stable) for 22 (95.8%) within 2 months of starting voriconazole and for 20 (83.3%) at the last follow-up. "