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Blastomycosis
Medical condition / From Wikipedia, the free encyclopedia
Blastomycosis, also known as Gilchrist's disease, is a fungal infection, typically of the lungs, which can spread to brain, stomach, intestine and skin, where it appears as crusting purplish warty plaques with a roundish bumpy edge and central depression.[2][7] Around half of people with the disease have symptoms, which can include fever, cough, night sweats, muscle pains, weight loss, chest pain, and fatigue.[5] Symptoms usually develop between three weeks and three months after breathing in the spores.[5] In 25% to 40% of cases, the infection also spreads to other parts of the body, such as the skin, bones or central nervous system.[8] Although blastomycosis is especially dangerous for those with weak immune systems, most people diagnosed with blastomycosis have healthy immune systems.[8]
Blastomycosis | |
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Other names | Blasto,[1] North American blastomycosis,[2] Chicago disease[3] |
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Lung infiltration in blastomycosis. | |
Specialty | Infectious disease[4] |
Symptoms |
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Causes | Blastomyces dermatitidis[2] |
Treatment | Antifungals[6] |
Medication | Itraconazole, amphotericin B[6] |
Blastomyces dermatitidis is found in the soil and decaying organic matter like wood or leaves.[6] Outdoor activities like hunting or camping in wooded areas increase the risk of developing blastomycosis.[9] There is no vaccine, but the risk of the disease can be reduced by not disturbing the soil.[9] Treatment is typically with an azole drug such as itraconazole for mild or moderate disease.[10] In severe cases, patients are treated with amphotericin B before azole treatment.[10] In either event, the azole treatment lasts for 6–12 months.[11] Overall, 4–6% of people who develop blastomycosis die; however, if the central nervous system is involved, this rises to 18%. People with AIDS or on medications that suppress the immune system have the highest risk of death at 25–40%.[12]
Blastomycosis is endemic to the eastern United States and Canada, especially the Ohio and Mississippi River valleys, the Great Lakes, and the St. Lawrence River valley.[6] In these areas, there are about 1 to 2 cases per 100,000 per year.[13] Less frequently, blastomycosis also occurs in Africa, the Middle East, India, and western North America.[8][14] Blastomycosis also affects a broad range of non-human mammals, and dogs in particular are an order of magnitude more likely to contract the disease than humans.[15] The ecological niche of Blastomyces in the wild is poorly understood, and it is unknown if there are any significant host animals.[16]
Blastomycosis has existed for millions of years but was first described by Thomas Caspar Gilchrist in 1894. Because of this, it is sometimes called "Gilchrist's disease".[17]