infectious diseases
Blastomycosis
Key Points
Inhaling spores of the dimorphic fungusBlastomycescan cause pulmonary disease and, less commonly, disseminated infection (particularly to the skin). In North America, blastomycosis is endemic in the regions around the Great Lakes and the Ohio–Mississippi River valleys (extending into the middle Atlantic and southeastern states). Diagnose using cultures of infected material; serologic testing is specific but not very sensitive. For mild to moderate disease, useitraconazole. For severe disease, useamphotericin B. 