Blastomycosis

In the Blastomycosis it is an infectious disease. In blastomycosis, the affected people become infected with the pathogen Blastomyces dermatitidis. Blastomycosis occurs more frequently in certain regions of the world. For example, blastomycosis occurs in the southern and eastern United States of America and the Mississippi Basin.Increased cases of blastomycosis are also known from Africa and Central America.

What is blastomycosis?

When blastomycosis affects the lungs, it usually manifests itself in rather unspecific symptoms. As a result of pulmonary blastomycosis, patients mainly suffer from symptoms that are similar to those of the flu.
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Blastomycosis is an infectious disease resulting from infection with a certain pathogen. Basically, medicine divides blastomycosis into three different forms, which are mainly based on the area in which it spreads. There is a North American blastomycosis, a European blastomycosis and a South American blastomycosis.

The European blastomycosis is also called Cryptococcosis or Cryptococcus mycosis known. The cause of European blastomycosis is found in a pathogen called Cryptococcus neoformans or Cryptococcus bacillisporus. North American blastomycosis develops in patients as a result of infection with Blastomyces dermatitidis.

This form of blastomycosis manifests itself in inflammation of the bronchi at the beginning of the disease. In addition, North American blastomycosis affects the skin and lungs of the sick people. With North American blastomycosis, patients usually lose a lot of weight and become emaciated. This form of blastomycosis is concentrated in North America and is also known under the names Gilchrist's disease or Gilchrist's disease.

In South American blastomycosis, the pathogen is found in a fungus called Paracoccidioides brasiliensis. This form of blastomycosis is associated with a variety of changes in the skin. As a result, ulcers develop on certain areas of the skin. The tumors also develop preferentially in the area of ​​the lymph nodes and on the mucous membrane. South American blastomycosis is concentrated in the rural regions of Latin America.

South American blastomycosis is particularly common in Brazil. Because the fungus benefits from the mild air temperatures and the high moisture content in the air. In the majority of cases, male patients develop South American blastomycosis who have already passed the third decade of life. Blastomycosis occurs less frequently in women or children. South American blastomycosis leads to the death of sick patients in up to 25 percent of cases.

causes

The causes of blastomycosis have already been researched comparatively well, so that medical professionals largely understand the mechanisms of the pathogenesis. Blastomycosis is triggered by special pathogens, usually types of fungus.

Blastomyces dermatitidis is a filamentous fungus that lives in the soil. The fungus is transmitted to humans either through the air or through contact with the skin. As soon as the fungus has penetrated the human organism, it multiplies in the area of ​​the lungs in the form of yeast.

Symptoms, ailments & signs

When blastomycosis affects the lungs, it usually manifests itself in rather unspecific symptoms. As a result of pulmonary blastomycosis, patients mainly suffer from symptoms that are similar to those of the flu. In some cases, however, the signs of blastomycosis spread to tuberculosis-like symptoms. In addition, there is a dissemination that develops particularly on the bones. Sometimes fistulas develop in the skin.

In some cases, the cutaneous expression of blastomycosis is formed by direct inoculation of the pathogen Blastomyces dermatitidis. On the other hand, it is possible that the pathogen spreads from the lungs to other areas of the body. The blastomycosis often manifests itself in small nodules that resemble a granuloma. As the blastomycosis progresses, ulcerations sometimes develop in these nodules, resulting in scarring.

diagnosis

The diagnosis of blastomycosis must be made by a specialist doctor and also depends on the form of the disease. In the case of cutaneous blastomycosis, for example, it is advisable to consult a dermatologist. As part of the anamnesis, the doctor tries to find out whether there has been any possible contact with the pathogens in the recent past. If the patient recently visited a corresponding risk area for blastomycosis, this also serves as an important indication.

The diagnosis of blastomycosis is mainly based on histological examination of tissue samples. On the one hand, it is possible to take samples of the pus from diseased skin areas and examine them using a microscope. An analysis of the sputum is also possible. In addition, bronchial lavage is sometimes used to diagnose blastomycosis. In the case of deceased people, a biopsy can be used to prove that blastomycosis is the cause of death.

Complications

Fungal diseases such as blastomycosis are often critical complications in seriously ill patients. People with a weakened immune status are particularly at risk. In addition to long-term therapy with corticosteroids, cytostatic treatments and immunosuppression after an organ transplant are among the greatest risk factors for those affected from western industrialized countries.

Diseases such as leukemia, malignant lymphoma or AIDS also favor the occurrence of opportunistic fungal infections. A dreaded complication of blastomycosis is the systemic spread of the pathogen, which can affect the gastrointestinal tract, the skeleton, the CNS, the prostate and the epididymis. Due to the massively weakened immune system, the fungi do not stay in the lungs or the skin, but are distributed in the body via the blood and lymph vessels.

If left untreated, the serious complications show rapid progression and are often fatal. Thanks to effective antimycotics, systemic blastomycosis can be cured if diagnosed in good time. Possible complications of blastomycosis include pneumonia, acute respiratory failure (ARDS), herd encephalitis and pleural effusion. Fever of unknown cause is also possible, as well as granulomatous prostatitis, erythema nodosum and irritable bowel syndrome.

When should you go to the doctor?

Since blastomycosis can multiply relatively quickly throughout the body, a doctor should definitely be consulted if the complaints and symptoms of this disease occur. As a rule, those affected suffer from the symptoms of typical flu.

However, if these symptoms persist over a longer period of time and do not go away with the help of treatment, a doctor must be consulted in any case. The formation of fistulas on the skin can also indicate blastomycosis, so the skin should be examined.

It is not uncommon for patients to suffer from breathing difficulties due to blastomycosis. Lumps can form on the skin and continue to change color. Should these complaints arise, a doctor must be consulted immediately. If there is no treatment, the affected person usually dies as a result of the blastomycosis.

In acute and urgent emergencies, the hospital should be visited directly. A dermatologist or general practitioner can be seen to diagnose the disease. Successful treatment does not reduce the patient's life expectancy.

Doctors & therapists in your area

Treatment & Therapy

Prompt treatment of blastomycosis is very important in any case, as the disease is often fatal without treatment. The patients usually receive drug treatment with the active ingredients amphotericin B or itraconazole. Continuous medical monitoring of the progress of therapy is essential for blastomycosis and improves the likelihood of survival of the sick person.

Outlook & forecast

The prospect of a cure for blastomycosis depends on the general state of health of the patient and the time at which medical care is sought.

Without medical treatment, the symptoms increase steadily. Health deteriorates, the patient becomes increasingly weaker and the person concerned ultimately becomes critical. Due to the progressive course of the disease, the patient's death is very likely.

The later medical care is sought, the lower the chance of recovery. People with a weakened immune system and various previous illnesses also meet very unfavorable conditions for recovery. In many cases, the body's own defenses and available resources are no longer sufficient to successfully face the pathogens in the organism.

A good prognosis can be given to people who seek drug treatment as early as possible, who are sufficiently physically fit and have a stable and healthy immune system. If the instructions of the attending physician are followed, the patient can be relieved of symptoms within a few weeks and the patient is discharged from the treatment as cured.

In addition to the drug therapy, a healthy and balanced diet helps to shorten the healing process. If blastomycosis occurs again, treatment should be initiated as soon as possible to increase the chances of survival.

prevention

A prevention of blastomycosis is possible in part if patients in the known risk areas behave particularly carefully and if possible avoid contact with soil. However, safe prevention is not possible in this way.

Aftercare

In the case of blastomycosis, aftercare primarily focuses on examining the patient's organism for residues of the pathogen at regular intervals. The patient should have regular checkups. The doctor can take further measures, depending on whether the fungal infection has been completely overcome or whether there are still pathogens in the body.

Depending on the type of blastomycosis, additional blood tests may also be required as part of follow-up care. This ensures that the pathogen has left the organism. Since blastomycoses can be fatal, there is always a burden for the patient. Therefore, therapy or a consultation with a psychologist should accompany the treatment of the physical symptoms.

If the outcome is positive, two to three follow-ups are sufficient. If complications or long-term consequences arise, the therapy must be continued. Follow-up care can therefore last several months or even years, as blastomycosis can recur. If you haven't already, determining the cause of the yeast infection can also be part of the follow-up. In any case, the patient should discuss further measures to be taken after therapy with the responsible doctor.

You can do that yourself

Blastomycosis is an extremely serious infectious disease and requires immediate medical therapy. In order to increase their own chances of survival, the sick patients therefore turn to a doctor as soon as they notice the first signs of illness.

This is almost the only way for people with blastomycosis to help themselves, as doctors and nursing staff then take care of the patient. The sick person usually goes to a clinic and receives intensive medical treatment and supervision there. If left untreated, the probability of dying from blastomycosis is extremely high, although this risk persists even with adequate therapy.

The patient adheres to prescribed bed rest and refrains from unnecessary physical activity. He takes the prescribed medication at set times and reports any possible side effects to the clinic staff. Under no circumstances should the patient become infected with other pathogens during blastomycosis, as this puts additional strain on the immune system and reduces the likelihood of survival. Treatment in quarantine therefore makes sense and must be complied with by the patient.

The patient only takes the meals prescribed by the medical staff in the clinic and, if necessary, receives artificial food through intravenous infusions if the weakness caused by the blastomycosis is too pronounced.