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Blastomycosis Differential Diagnoses

  • Author: Chidinma Chima-Okereke, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
 
Updated: Feb 18, 2015
 
 

Diagnostic Considerations

Blastomycosis should be considered in the differential diagnosis of an atypical pulmonary infection in regions where it is endemic, even in urban areas.

Blastomycosis may present as a community-acquired pneumonia; in addition, it should be considered in any patient with pneumonia that is not resolving, or one who presents with acute respiratory distress syndrome. Other pulmonary disorders to consider in the differential diagnosis are sarcoidosis, tuberculosis, and other endemic mycoses.

Blastomycosis has a propensity to mimic carcinoma. Pulmonary blastomycosis may resemble lung cancer, and blastomycosis osteomyelitis may resemble bony metastasis. The typical verrucous or ulcerative cutaneous lesions of blastomycosis may mimic skin cancers, such as basal cell carcinoma and squamous cell carcinoma. Central nervous system blastomycosis may resemble brain neoplasm.

Skin disorders to consider include the following:

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Chidinma Chima-Okereke, MD Fellow in Pulmonary and Critical Care Medicine, Lung Institute, Cedars Sinai Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, FACP, FCCP Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society

Disclosure: Nothing to disclose.

Acknowledgements

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases,Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society

Disclosure: Nothing to disclose.

Michael Peterson, MD Chief of Medicine, Vice-Chair of Medicine, University of California, San Francisco, School of Medicine; Endowed Professor of Medicine, University of California, San Francisco-Fresno, School of Medicine

Michael Peterson, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Avinash Shetty, MD Department of Pediatrics, Division of Pediatric Infectious Diseases, Assistant Professor of Pediatrics, Wake Forest University School of Medicine

Avinash Shetty, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Basil Varkey, MD, FCCP Professor Emeritus, Department of Internal Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin; Consulting Pulmonologist, Froedtert Memorial Lutheran Hospital

Basil Varkey, MD, FCCP is a member of the following medical societies: American Association of Physicians of Indian Origin and American College of Chest Physicians

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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Cutaneous blastomycosis.
Lateral chest radiograph reveals the ill-defined lingular opacity and an absence of pleural effusions.
Composite photomicrograph of a tissue specimen from a patient with blastomycosis infection shows an abundance of large budding cells that had been configured in chains. Courtesy of CDC/Dr. Lucille K. George.
 
 
 
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