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:

Networked: 395 relevant articles (53 outcomes, 30 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Hage, Chadi A: 8 articles (04/2014 - 01/2007)
2.	Wheat, L Joseph: 8 articles (02/2014 - 11/2006)
3.	Bradsher, Robert W: 5 articles (01/2014 - 04/2008)
4.	Klein, B S: 5 articles (12/2007 - 02/2000)
5.	Scalarone, G M: 5 articles (09/2005 - 10/2002)
6.	Kauffman, Carol A: 4 articles (08/2012 - 06/2008)
7.	Durkin, Michelle: 4 articles (02/2011 - 10/2004)
8.	Durkin, Michelle M: 3 articles (11/2015 - 03/2012)
9.	Davis, Thomas E: 3 articles (02/2014 - 01/2007)
10.	Klein, Bruce S: 3 articles (02/2014 - 06/2002)

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. " 01/01/1993 - "Therapy of blastomycosis has been broadened with the addition of ketoconazole. "
2.	Amphotericin B (Amphotericin)FDA LinkGeneric 03/01/2008 - "The patient was treated successfully with amphotericin for blastomycosis of the eye, lung, and thyroid. " 12/01/1985 - "Amphotericin B is effective in therapy for blastomycosis but causes a number of serious adverse reactions. " 04/01/1967 - "[Multivisceral blastomycosis with pulmonary predominance in a Frenchman of Tunisian origin cured by amphotericin B]." 01/01/2015 - "Classically, cerebral blastomycosis has been treated with amphotericin B. " 05/01/2012 - "The lipid formulation of amphotericin B is the initial drug of choice for central nervous system blastomycosis, but it is costly and associated with significant toxicity. "
3.	AntigensIBA 03/01/2014 - "Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis." 12/01/1995 - "Serologic tests for the diagnosis of blastomycosis have had inadequate sensitivity, but results are improved with enzyme immunoassay (EIA) with A-antigen of Blastomyces dermatitidis. " 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. " 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. " 04/01/2004 - "The study may prove valuable in the development of antigen candidates for blastomycosis serodiagnosis."
4.	Itraconazole (Sporanox)FDA LinkGeneric 03/01/2013 - "Successful treatment of pulmonary blastomycosis in a pregnant woman using itraconazole." 05/01/2011 - "Itraconazole is recommended for treatment of blastomycosis in dogs. " 04/15/2004 - "To compare prevalence of organisms and histologic changes in eyes from dogs with blastomycosis that were either untreated or undergoing treatment with itraconazole. " 04/01/2004 - "Chronic blastomycosis should always be treated with systemic antifungal therapy, and oral itraconazole is the drug of choice for mild to moderate forms of the disease. " 04/01/2000 - "Thus, itraconazole is the initial treatment of choice for nonlife-threatening non-CNS blastomycosis."
5.	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. " 08/01/1997 - "To examine the usefulness of higher doses of fluconazole therapy for this disorder, we conducted a multicenter, randomized, open-label study to determine the efficacy and safety of two different daily doses of fluconazole (400 and 800 mg) in the treatment of non-life-threatening 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. " 05/01/2012 - "This case report details a patient with primary pulmonary blastomycosis with dissemination to the skin, one joint, and the brainstem that was successfully treated solely with high-dose fluconazole."
6.	voriconazole (Vfend)FDA LinkGeneric 02/01/2001 - "We evaluated the efficacy of voriconazole, a new broad-spectrum triazole antifungal compound, in the treatment of murine pulmonary blastomycosis. " 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. " 10/01/2009 - "Search terms included voriconazole, blastomyces, blastomycosis, CNS, cerebral, and central nervous system. "
7.	liposomal amphotericin BFDA Link 12/15/1996 - "Amphotericin B lipid complex was a safe and effective treatment for blastomycosis in these dogs." 05/01/2001 - "This is the first reported case of cerebral blastomycosis successfully treated with amphotericin B lipid complex." 12/15/1996 - "To evaluate efficacy and nephrotoxicity of amphotericin B lipid complex used for treatment of dogs with naturally developing blastomycosis. " 12/15/1996 - "Use of an amphotericin B lipid complex for treatment of blastomycosis in dogs." 04/01/2006 - "Recurrent central nervous system blastomycosis in an immunocompetent child treated successfully with sequential liposomal amphotericin B and voriconazole."
8.	Miconazole (Monistat)FDA LinkGeneric 06/01/1979 - "Blastomycosis treated successfully with miconazole." 06/01/1979 - "Miconazole seems to be effective and safe in the treatment of blastomycosis." 10/15/1993 - "Subconjunctival miconazole and anterior segment blastomycosis." 06/01/1979 - "A case of disseminated blastomycosis is described, which was treated with miconazole orally. " 08/01/1978 - "Miconazole treatment of relapsed pulmonary blastomycosis."
9.	Systemic candidiasisIBA 01/01/1985 - "Effective clinical use has been demonstrated in patients with cutaneous and systemic candidiasis, aspergillosis, blastomycosis, coccidioidomycosis, cryptococcus and systemic candidiasis, aspergillosis, blastomycosis, coccidioidomycosis, cryptococcus and histoplasmosis. " 03/01/1989 - "Similarly, good to excellent response rates (clinical cure or marked improvement) are achieved in paracoccidioidomycosis, histoplasmosis, sporotrichosis, blastomycosis, systemic candidiasis, coccidioidomycosis, chromomycosis, aspergillosis and cryptococcosis. " 01/24/1983 - "Excellent results were obtained in six cases of chronic mucocutaneous candidiasis, with restoration of immunologic disturbances; 23 cases of systemic candidiasis, including new aspects of heroin addicts with cutaneous, ocular, or osteoarticular manifestations; eight cases of histoplasmosis, five due to Histoplasma capsulatum and three to Histoplasma duboisii, with cure in seven and remission in one; one case of African blastomycosis (Blastomyces dermatitidis); three cases of mycetoma, two due to Monosporium apiospermum, one due to a dematiacious fungus; three cases of entomophthoromycosis with cure; one case of fungal arthritis, due to new hyphomycete similar to M. "
10.	nikkomycinIBA 09/01/1997 - "Efficacy of nikkomycin Z against experimental pulmonary blastomycosis." 09/01/1997 - "Overall, nikkomycin Z given orally was well tolerated, had good activity against blastomycosis, and could result in biological cure, thus producing results equivalent to those of parenteral amphotericin B." 09/01/1997 - "In vitro, nikkomycin Z had good activity against Blastomyces dermatitidis, with an MIC of 0.78 microg/ml and a minimal fungicidal concentration of 3.1 microg/ml. The efficacies of various treatment durations (3, 5, or 10 days) and doses (200, 400, or 1,000 mg/kg of body weight) of nikkomycin Z given twice daily were compared with those of itraconazole at 200 mg/kg given twice daily and amphotericin B at 6.25 mg/kg in a murine model of pulmonary blastomycosis. " 04/01/1990 - "In vivo, nikkomycin Z was more effective than nikkomycin X, was also found to be superior on a milligram per milligram basis to the majority of azoles tested in the models of coccidioidomycosis and blastomycosis, and was moderately effective in histoplasmosis. "

Therapies and Procedures

1.	Transplantation (Transplant Recipients) 01/01/1993 - "Other reported cases of blastomycosis in transplant recipients are summarized. " 01/01/1993 - "Blastomycosis in transplant recipients: report of a case and review." 06/01/1990 - "A case of disseminated blastomycosis in a male renal transplant recipient is presented. " 10/01/1985 - "A renal transplant recipient presented with pulmonary blastomycosis. " 12/01/1984 - "Disseminated inoculation blastomycosis in a renal transplant recipient."
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.	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. "
5.	Transplants (Transplant) 08/01/2014 - "Peritoneal blastomycosis is a rare clinical entity and, to our knowledge, this patient represents the first known case of peritoneal blastomycosis in a solid organ transplant recipient. " 07/01/2009 - "We describe a patient who underwent a renal transplant and developed pulmonary blastomycosis." 12/01/2007 - "After cure, post-transplant blastomycosis may not require lifelong antifungal suppression." 12/01/2007 - "Rejection did not precede any case of post-transplant blastomycosis. " 12/01/2007 - "From 1986 to 2004, we identified 11 cases of post-transplant blastomycosis with 64% occurring between 2000 and 2004. "