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Vet J 2021 Jun 10;274:105707. Epub 2021 Jun 10.

Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, 2015 Linden Dr, Madison, WI, 53706, USA. Electronic address:

Blastomycosis is a prominent fungal disease in the United States. Vitamin D status has been found to be altered in critical illness and various infectious diseases. The objectives of this study were to compare serum 25-hydroxyvitamin D (25[OH]D) concentrations in dogs with blastomycosis and healthy controls, to assess the change in serum 25(OH)D concentrations in dogs with blastomycosis after 30 days of treatment, and to determine if baseline serum 25(OH)D concentrations in dogs with blastomycosis were associated with in-hospital, 30-day, or end-of-study mortality. Read More

Transpl Infect Dis 2021 Jun 19:e13671. Epub 2021 Jun 19.

Department of Medicine, Medical College of Wisconsin, Wauwatosa, WI, 53226, United States of America.

Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Read More

Diagnostics (Basel) 2021 May 10;11(5). Epub 2021 May 10.

Department of Internal Medicine, Division of Infectious Diseases, University of Kansas, Kansas City, KS 66160, USA.

Endemic mycoses including , , , , and are dimorphic fungi that can cause a variety of clinical manifestations, including respiratory infections. Their pulmonary presentations are variable, and diagnosis is often delayed as they can mimic other infectious and non-infectious causes of pulmonary disease. Delay in diagnosis can lead to unnecessary antibiotic use, repeat hospitalizations, and increased morbidity and mortality. Read More

BMJ Case Rep 2021 05 31;14(5). Epub 2021 May 31.

Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

CMAJ 2021 May;193(21):E770

Department of Internal Medicine, University of Manitoba, Winnipeg, Man.

IDCases 2021 9;24:e01156. Epub 2021 May 9.

Infectious Disease Department, ASST-Settelaghi and University of Insubria, Varese, Italy.

Infect Dis Clin North Am 2021 Jun;35(2):515-530

Division of Infectious Diseases, Department of Medicine, Washington University, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO 63110, USA. Electronic address:

Blastomycosis is the fungal disease caused by thermally dimorphic fungi in the genus Blastomyces, with B dermatitidis complex causing most cases. It is considered hyperendemic in areas adjacent to the Great Lakes and along the St. Lawrence, Mississippi, and Ohio rivers, but definitive geographic distribution of blastomycoses remains obscure. Read More

Pediatr Infect Dis J 2021 May 7. Epub 2021 May 7.

From the Department of Pediatrics, Medical College of Wisconsin, Wauwatosa, Wisconsin; Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri; Department of Pediatrics, Quantitative Health Sciences, Medical College of Wisconsin, Wauwatosa, Wisconsin; and Department of Pathology, Medical College of Wisconsin, Wauwatosa, Wisconsin.

Background: Blastomycosis, an endemic mycosis of immunocompetent individuals, is typically seen after exposure to waterways within rural wooded regions. It is not considered a disease of urban environments. Infection can be solely pneumonic or disseminate to skin, bone or central nervous system. Read More

Eur J Case Rep Intern Med 2021 23;8(4):002511. Epub 2021 Apr 23.

Department of Cardiovascular Medicine, Mayo Clinic Alix School of Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin, USA.

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of acute coronary syndrome (ACS) and myocardial infarction (MI) in individuals with few or no known atherosclerotic risk factors. While systemic autoimmune inflammatory disorders are associated with precipitating SCAD, the role of infection-induced systemic inflammation in SCAD is not well defined. We present the case of a 49-year-old Caucasian woman with ST-elevation myocardial infarction (STEMI) diagnosed as SCAD from a severe systemic inflammatory response related to disseminated blastomycosis. Read More

J Foot Ankle Surg 2021 Mar 26. Epub 2021 Mar 26.

Attending Physician, Swedish American Hospital, Rockford, IL.

Blastomycosis is a rare condition affecting specific endemic areas in North America. Blastomycosis is characterized primarily as a pulmonary disease but can disseminate to affect other organ systems. Osteomyelitis due to disseminated blastomycosis is a rare condition with limited functional reconstructive options in a young adult. Read More

Clin J Am Soc Nephrol 2021 Apr 20. Epub 2021 Apr 20.

Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio

Infections remain a common complication of solid-organ transplantation. Most infections in the first month after transplant are typically health care-associated infections, whereas late infections, beyond 6-12 months, are community-acquired infections. Opportunistic infections most frequently present in the first 12 months post-transplant and can be modulated on prior exposures and use of prophylaxis. Read More

Transpl Infect Dis 2021 Apr 20:e13618. Epub 2021 Apr 20.

Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Disseminated blastomycosis in solid organ transplant is uncommon. The diagnosis is usually challenging due to vague clinical presentations, which could lead to a devastating outcome. We reported a unique case of disseminated blastomycosis with laryngeal involvement in a kidney transplant recipient who presented with hoarseness. Read More

Ear Nose Throat J 2021 Apr 18:1455613211006001. Epub 2021 Apr 18.

Carle Illinois College of Medicine, Champaign, IL, USA.

The aim of this report is to document a very rare case of mastoiditis with extension into the retromastoid soft tissue and surrounding muscle. is a dimorphic fungus of endemic areas which classically infiltrates the lungs; however, dissemination presenting as otomastoiditis is exceedingly rare. The patient was an immunocompetent 27-year-old male with no significant preexisting health conditions. Read More

SN Compr Clin Med 2021 Mar 27:1-12. Epub 2021 Mar 27.

Department of Oral Pathology, Meghna Institute of Dental Sciences, Nizamabad, Telangana India.

The frequency of fungal infections is increasing due to immunodeficiency viruses and immunosuppressive drugs. The most common fungal infection of the oral cavity is candidiasis. The existence of can be a part of normal commensal; hence, the isolation of in the absence of clinical symptoms should exclude candidiasis. Read More

Emerg Infect Dis 2021 Apr;27(4)

J Appl Microbiol 2021 Mar 23. Epub 2021 Mar 23.

Faculty of Biological Sciences, Department of Mycology and Genetics, Institute of Genetics and Microbiology, University of Wroclaw, Wroclaw, Poland.

Fungal infections are still underappreciated and their prevalence is underestimated, which renders them a serious public health problem. Realistic discussions about their distribution, symptoms, and control can improve management and diagnosis and contribute to refinement of preventive actions using currently available tools. This article represents an overview of dermatophytes and endemic fungi that cause infections in humans and animals. Read More

S D Med 2020 Dec;73(12):586-587

Sanford Dermatology Clinic, Sioux Falls, South Dakota.

Blastomyces is a fungus that is endemic to the Ohio and Mississippi River Valleys and Great Lakes region. The fungus is a rare cause of infection, but most commonly causes infections of the lungs followed by the skin and bones. Infection of the bone is often not clinically suspected, which can slow the diagnosis. Read More

Ear Nose Throat J 2021 Mar 8:145561321991342. Epub 2021 Mar 8.

Integrated Research and Development Laboratory, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.

Otolaryngologic manifestations of infection with species are extremely rare and restricted geographically to recognized endemic regions. Here, we describe a case of laryngeal blastomycosis that presented as slowly progressive dysphonia. While a preliminary diagnosis was made using routine histopathology, a species identification of was made using polymerase chain reaction amplification and rapid genotyping without the need for fungal culture. Read More

BMJ Case Rep 2021 Feb 22;14(2). Epub 2021 Feb 22.

Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Canada

While blastomycosis is endemic to eastern USA and northwestern Ontario, acquisition is an anomaly in urban settings. We present a 54-year-old immunocompetent man from the greater Toronto area with no travel, who presented with a 3-week history of chest pain and dyspnoea. Initial radiographic workup revealed a mass-like opacification in the right apical mediastinum. Read More

J Vet Intern Med 2021 Mar 19;35(2):946-953. Epub 2021 Feb 19.

Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA.

Background: The Blastomyces antigen concentration in urine (BACU) test is used to diagnose blastomycosis and monitor treatment in dogs. It is unknown if a higher BACU is associated with shorter survival.

Objectives: To determine if the magnitude of BACU before treatment is associated with survival in dogs with blastomycosis. Read More

Orbit 2021 Feb 15:1-5. Epub 2021 Feb 15.

Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.

Following effective treatment with systemic antifungal therapy, eyelid lesions from blastomycosis infection may be replaced by disfiguring fibrosis and scarring, which may be surgically challenging to correct. A 68-year-old man with biopsy-proven eyelid blastomycosis was treated with 6 months of oral voriconazole, but resolution of the lesion was complicated by cicatricial changes causing complete lower eyelid defect, epicanthal web, cicatricial mechanical ptosis, and skin plaques. Although repair adhered to the fundamentals of eyelid reconstruction, cicatricial changes associated with blastomycosis infection necessitated a modified approach and attachment sites. Read More

Radiographics 2021 Mar-Apr;41(2):380-398. Epub 2021 Feb 5.

From the Department of Clinical Radiology, University of Missouri-Columbia, 1 Hospital Dr, Columbia, MO 65212 (J.R.K., A.H.); Department of Radiology, University of Southern California, Los Angeles, Calif (L.F.B.); Departments of Diagnostic Radiology (C.F.) and Pathology (D.S.), Oregon Health Sciences & University, Portland, Ore; and Department of Diagnostic Radiology, University of Kansas Medical Center, Kansas City, Kan (C.M.W.).

The digitization of radiographic studies along with high-speed transmission of images has formed the basis of teleradiology, which has become an integral component in the workflow of a contemporary radiology practice. It is with this advent and growing utilization of teleradiology that the significance of the source location of images has gained importance. Specifically, the importance of where the patient resides and what endemic fungi occur in that location cannot be underestimated. Read More

J Cutan Med Surg 2021 Feb 5:1203475420988864. Epub 2021 Feb 5.

7985266277985 Division of Dermatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful and ulcerating lesions on the skin. It rarely involves the face and is often difficult to diagnose. There are few cases reported in the literature of PG involving the face. Read More

WMJ 2020 Dec;119(4):289-292

Medical College of Wisconsin - Green Bay, De Pere, Wisconsin.

Introduction: Pulmonary blastomycosis is a rare fungal disease with increased prevalence in states such as Wisconsin. Clinical manifestations of blastomycosis may vary from asymptomatic infection to multiorgan, disseminated disease.

Case Presentation: We present 2 pediatric patients with blastomycosis who were initially worked up secondary to cough and fever of suspected bacterial origin, though whose subsequent hospital course was notable for deterioration until antifungal treatment was initiated. Read More

Front Cell Infect Microbiol 2020 14;10:595301. Epub 2020 Dec 14.

Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellin, Colombia.

Systemic and endemic mycoses are considered life-threatening respiratory diseases which are caused by a group of dimorphic fungal pathogens belonging to the genera , , , , , and the newly described pathogen . T-cell mediated immunity, mainly T helper (Th)1 and Th17 responses, are essential for protection against these dimorphic fungi; thus, IL-17 production is associated with neutrophil and macrophage recruitment at the site of infection accompanied by chemokines and proinflammatory cytokines production, a mechanism that is mediated by some pattern recognition receptors (PRRs), including Dectin-1, Dectine-2, TLRs, Mannose receptor (MR), Galectin-3 and NLPR3, and the adaptor molecules caspase adaptor recruitment domain family member 9 (Card9), and myeloid differentiation factor 88 (MyD88). However, these PRRs play distinctly different roles for each pathogen. Read More

J Fungi (Basel) 2020 Dec 29;7(1). Epub 2020 Dec 29.

Infectious Diseases Section, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, MI 48105, USA.

The diagnosis of blastomycosis and histoplasmosis can be difficult for clinicians who rarely see infections caused by these environmentally restricted dimorphic fungi. Historically, the diagnosis of blastomycosis has been established by culture and sometimes by histopathologic identification. Currently, antigen detection in urine and serum has been shown to aid in the rapid diagnosis of blastomycosis, and newer antibody assays are likely to contribute to our diagnostic capability in the near future. Read More

Appl Environ Microbiol 2020 Dec 18. Epub 2020 Dec 18.

Department of Microbiology and Immunology, University of Minnesota, Minneapolis, Minnesota, USA

Outbreaks of blastomycosis, caused by the fungus , occur in endemic areas of the United States and Canada but the geographic range of blastomycosis is expanding. Previous studies inferred the location of through epidemiologic data associated with outbreaks because culture of from the environment is often unsuccessful. In this study, we used a culture-independent, PCR-based method to identify DNA in environmental samples using the BAD1 promoter region. Read More

J Clin Microbiol 2021 Feb 18;59(3). Epub 2021 Feb 18.

Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA

Blastomycosis due to and is a significant cause of respiratory mycoses in North America with occasional reported outbreaks. We developed a highly sensitive, specific, and reproducible TaqMan duplex real-time PCR assay for the differentiation of and The new assay permitted retrospective analysis of cultures (2005 to 2019) and primary clinical specimens from blastomycosis cases (2013 to 2019) from New York patients. We identified as the predominant pathogen in 38 cases of blastomycosis, while was a minor pathogen involved in five cases; these findings expand understanding of blastomycosis in New York. Read More

Oxf Med Case Reports 2020 Nov 24;2020(11):omaa093. Epub 2020 Nov 24.

Department of Infectious Diseases, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.

Blastomyces dermatitidis is an endemic mold infection commonly seen in the midwestern of the USA and rarely affects pregnant women. The most common presentation is a pulmonary infection with variable degrees of severity. Of note, the clinical and radiographic findings of pulmonary blastomycosis can be mistaken for other pulmonary pathologies, thus earning the title of 'the great pretender'. Read More

Arthritis Rheumatol 2021 01 17;73(1):21-22. Epub 2020 Nov 17.