Blastomycosis in New England: 5 Cases and a Review

Abstract

The geographic range of blastomycosis is thought to include New England, but documentation is sparse. We report five cases of infection with Blastomyces dermatitidis which were likely acquired in New England between 2011 and 2021. Our experience suggests that chart coding for the diagnosis of blastomycosis is imprecise, and that mandatory reporting might help resolve uncertainties about the prevalence and extent of blastomycosis.

Using Insurance Claims Data to Estimate Blastomycosis Incidence, Vermont, USA, 2011–2020

“…Our findings, based on the most comprehensive assessment of blastomycosis in Vermont to date, align with a growing body of evidence suggesting that the burden of endemic blastomycosis is greater than commonly appreciated (6)(7)(8)(9). These results challenge routine assumptions about the epidemiology and ecology of this disease and reflect a need for future studies.…”

Blastomycosis-Associated Hospitalizations, United States, 2010–2020

“…However, we did observe higher rates of blastomycosis-associated hospitalizations in the Midwest and the South, aligning with the broad environmental distribution of Blastomyces . In addition, the occurrence of hospitalizations in other regions indicates that the geographic distribution of blastomycosis might be broader than previously recognized [ 2 , 3 ], and it is important for healthcare providers to note the potential for travel-associated blastomycosis cases [ 1 ]. Therefore, there is a need for ongoing awareness of blastomycosis throughout the country.…”

“…Blastomycosis is a fungal disease caused primarily by inhalation of Blastomyces dermatitidis and Blastomyces gilchristii spores. In the United States, these fungi live in the environment mainly in the midwestern, south central, and southeastern states, though infections have also been acquired outside these areas, suggesting that the geographic range is broader than is generally believed [ 1 , 2 , 3 ]. A newly described species, Blastomyces helicus , has also caused infections in humans and animals in the western regions of Canada and the United States [ 4 ].…”