Blastomycosis normally is an acute disease that usually
presents in people that spent much time near rivers. It is endemic in areas
near the Great Lakes and the Mississippi river valleys. It is very low in prevalence
less than 2 in 100,000. Because it usually presents as a non-specific flu-like illness
it is not usually identified unless there is an outbreak. If it becomes more
serious it usually presents as a chronic pulmonary disease. In rare cases it
may have central nervous involvement. This involvement is very serious and
involves death at higher rates. CSF
evaluation will present with elevated protein, normal to decreased glucose, and
a pleocytosis that is either lymphocytic or neutrophilic. Blastomycosis with
only CNS involvement without other evidence of infections is rare. Because CSF culture is insensitive it is
useful to assay for antigen to detect blastomycosis in the CSF. It is important
to be aware that the assay has crossreactions with H. capsulatum. Because of the mortality associated with
blastomycosis when there is CNS involvement it is necessary that one be careful
when identifying suspected blastomycosis. As laboratory scientists we can do
much to identify blastomycosis and the faster it is identified the sooner the
proper treatment can be engaged.
It is shocking that a fungal infection has such a high fatality rate. I look up more information about Blastomycosis and found that people who has diabetes is at higher risk for the infection. It’s kind of sad there is no way to prevent most of the fungal disease except try to avoid been exposed to the fungus.
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