Blastomycosis

Last Updated: 2020-08-11

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Gilchrist 1894-96 (depending on source).

North American blastomycosis, Chicago disease, Gilchrist's disease.

System mycosis caused by the dimorphic fungus, Blastomyces dermatitids.

  • America (whole continent), parts of Africa.
  • Mainly adult men are affected.
  • Pathogen: Blastomyces dermatitidis
  • The pathogen is in the ground. Pulmonary inoculation occurs through the air. Hematogenous scattering leads to the involvement of other organs (skin, prostate, bones)

Curved, erythematous, partly ulcerating, partly crusty papules, papulopustules and nodi. Black, punctiform papillary vessels and peripheral miliary abscesses are centrally located.

  • Clinical features
  • Detection of pathogens by myco-smear and biopsy

Hands, feet, face and trunk.

  • No treatment for immunocompetent patients.
  • Therapy must be carried out for several months.
  • Amphotericin B i.v., initial: 0.1 mg/kg bw/d., if necessary increase the dose up to 1 mg/kg bw/d
  • Itraconazole p.o. 200 mg 1x daily
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