Blastomycosis
Anthony Chang, MD
Key Facts
Etiology/Pathogenesis
Blastomyces dermatitidis
Endemic to central/southern United States, Canada
Reported in Central/South America, Europe, and Africa
Ubiquitous dimorphic fungus acquired by inhalation
Macroscopic Features
Abscesses
Microscopic Pathology
Microorganisms, fungus
Thick wall, 8-15 µm in diameter
Broad-based budding
Granulomatous inflammation
Top Differential Diagnoses
Cryptococcosis
Coccidioidomycosis
 Hematoxylin & eosin shows a microabscess with necrosis  , neutrophils  , and numerous round yeast forms  in the renal cortex of this kidney involved by disseminated blastomycosis. |
 GMS (Gomori methenamine-silver) reveals Blastomyces with a broad-based budding yeast form  . The thick capsules  can resemble those of Cryptococcus and Coccidioides. |
TERMINOLOGY
Synonyms
North American blastomycosis
Gilchrist disease
Chicago disease
ETIOLOGY/PATHOGENESIS
Environmental Exposure
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