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Clinical manifestations and diagnosis of blastomycosis

Robert W Bradsher, Jr, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Blastomycosis is a systemic pyogranulomatous infection that arises after inhalation of the conidia of the thermally dimorphic fungus Blastomyces dermatitidis. Most cases of blastomycosis have been reported in North America. (See "Mycology, pathogenesis, and epidemiology of blastomycosis".)

The clinical manifestations of blastomycosis are varied and include asymptomatic infection, acute or chronic pneumonia, and extrapulmonary disease [1]. Although B. dermatitidis has been reported to involve almost every organ, the lungs are the most common site of infection, followed by the skin, bones, and genitourinary system. Extrapulmonary disease results from hematogenous spread from a primary pulmonary infection.

The clinical manifestations and diagnosis of blastomycosis will be reviewed here. The mycology, pathogenesis, epidemiology, and treatment of blastomycosis are discussed separately. (See "Mycology, pathogenesis, and epidemiology of blastomycosis" and "Treatment of blastomycosis".)


The lungs are the most common site of infection, followed by the skin, bones, and genitourinary tract [2,3]. As an example, in a study of 326 patients with blastomycosis, the following distribution of organ involvement was observed [2]:

Pulmonary – 91 percent

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Literature review current through: Nov 2017. | This topic last updated: May 11, 2016.
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