Blastomycosis in Wisconsin: Beyond the Outbreaks

Thompson, Katrina; Sterkel, Alana; Brooks, Erin G.

doi:10.23907/2017.014

Cited by 7 publications

(12 citation statements)

References 10 publications

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“…The known geographic range extends from the east coast of the United States [not including southern Florida] to the Mississippi River drainage in the west and from the gulf coast all the way into Ontario, Quebec, Manitoba, and Saskatchewan, Canada to the north [ 30 ]. Ecological niche modeling of Blastomyces around human and canine cases in Wisconsin identified proximity to waterways and moist soil were more predictive than soil characteristics, and one of the largest recorded outbreaks of blastomycosis occurred among boaters on the Little Wolf River [ 75 , 76 ]. Range expansion to the north has been spurred by case reports and case series in regions previously thought to be outside of the endemic zone [ 77 , 78 , 79 ] ( Table 1 ).…”

Section: Blastomyces Speciesmentioning

confidence: 99%

Endemic and Other Dimorphic Mycoses in The Americas

Lockhart

Toda

Benedict

et al. 2021

JoF

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Endemic fungi are thermally dimorphic fungi that have a limited geographic range and can cause both primary disease and opportunistic infections. The Americas are home to more genera of endemic fungi than anywhere else on earth. These include Coccidioides, Histoplasma, Blastomyces, Paracoccidioides, and Sporothrix. Endemic fungi are found across the Americas and the Caribbean, from Blastomyces gilchristi, which extends into the northeast corners of North America, to Histoplasma capsulatum, which occurs all the way down in the southern regions of South America and into the Caribbean Islands. Symptoms of endemic fungal infection, when present, mimic those of many other diseases and are often diagnosed only after initial treatment for a bacterial or viral disease has failed. Endemic fungi place a significant medical burden on the populations they affect, especially in immunocompromised individuals and in resource-limited settings. This review summarizes the ecology, geographical range, epidemiology, and disease forms of the endemic fungi found in the Americas. An emphasis is placed on new and proposed taxonomic changes, including the assignment of new species names in Histoplasma, Blastomyces, and Paracoccidioides.

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Section: Blastomyces Speciesmentioning

confidence: 99%

Endemic and Other Dimorphic Mycoses in The Americas

Lockhart

Toda

Benedict

et al. 2021

JoF

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“…7,[29][30][31][32][33] These have typically involved disruption of soil by anthropogenic activities such as construction and excavation 31,34 or outdoor activities, such as boating, camping, and hunting. 9,35,36 In one large outbreak, there was a clustering of cases among persons of Hmong ancestry. 33 This observation led to the identification of variability near the gene encoding interleukin-6 as one possible genetic influence of susceptibility to blastomycosis.…”

Section: Epidemiologymentioning

confidence: 99%

“…5,6 B. gilchristii predominates in the hyperendemic regions of northwestern Ontario and northern Wisconsin, 5 in which large outbreaks have been reported. [7][8][9] It is unclear if the increased incidence of blastomycosis in these regions relates to environmental factors, differential exposures, host vulnerability, or fungal virulence. Because the significance of distinguishing between B. gilchristii and B. dermatitidis has not been established, and considering that most historical reports of blastomycosis preceded the era of molecular genotyping, further discussion of B. dermatitidis applies to both species.…”

mentioning

confidence: 99%

Blastomycosis

Schwartz

Kauffman

2020

Semin Respir Crit Care Med

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Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic fungi belonging to the genus Blastomyces. The genetic and geographic diversity of these pathogens is greater than previously appreciated. In addition to Blastomyces dermatitidis and the cryptic species Blastomyces gilchristii, which cause blastomycosis in mid-western and various eastern areas of North America, atypical blastomycosis is occasionally caused by Blastomyces helicus in western parts of North America and Blastomyces percursus in Africa. Blastomycosis is acquired by inhalation of the conidia that are produced in the mold phase; in the lungs, temperature-dependent transformation occurs to the yeast phase. In this form, the organism is phagocytized by macrophages and can spread hematogenously to various organs causing disseminated infection. Pulmonary disease is most common and varies from mild, self-limited infection to severe, potentially fatal adult respiratory distress syndrome. Disseminated infection is manifested primarily by skin lesions, but many other organs can be involved. Diagnosis is established by growth of the organism in culture; however, a tentative diagnosis can be made quickly by histopathological identification of the classic yeast form in tissues or by finding Blastomyces antigen in urine or serum. Blastomycosis is treated initially with amphotericin B when the disease is severe, involves the central nervous system, or the host is immunosuppressed. Itraconazole is recommended for primary therapy in mild-to-moderate infection and for step-down therapy after initial amphotericin B treatment. Voriconazole and posaconazole can be used for patients in whom itraconazole is not tolerated.

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“…The geographic distribution of these Blastomyces species includes areas around the Great Lakes, the Mississippi and Ohio River Valleys, and the St. Lawrence seaway. B. gilchristii appears to be the predominant species in several localized regions in northwestern Ontario and northern Wisconsin, where large outbreaks of blastomycosis have occurred [ 2 , 3 ]. For clinical and diagnostic purposes, these can be viewed as the same organism, and we will refer to them both as B. dermatitidis throughout this review.…”

Section: Blastomycosismentioning

confidence: 99%

Current and New Perspectives in the Diagnosis of Blastomycosis and Histoplasmosis

Linder

Kauffman

2020

JoF

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The diagnosis of blastomycosis and histoplasmosis can be difficult for clinicians who rarely see infections caused by these environmentally restricted dimorphic fungi. Historically, the diagnosis of blastomycosis has been established by culture and sometimes by histopathologic identification. Currently, antigen detection in urine and serum has been shown to aid in the rapid diagnosis of blastomycosis, and newer antibody assays are likely to contribute to our diagnostic capability in the near future. The gold standard for the diagnosis of histoplasmosis has been culture of the organism from involved tissues, aided in some patients by histopathological verification of the typical yeast forms in tissues. Antigen detection has contributed greatly to the ability of clinicians to rapidly establish the diagnosis of histoplasmosis, especially in severely ill and immunocompromised patients, and antibody testing for Histoplasma capsulatum provides important adjunctive diagnostic capability for several forms of both acute and chronic histoplasmosis. For both of these endemic mycoses, novel molecular tests are under active investigation, but remain available in only a few reference laboratories. In this review, we provide a synopsis of diagnostic test options that aid in establishing whether a patient has blastomycosis or histoplasmosis.

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Blastomycosis in Wisconsin: Beyond the Outbreaks

Cited by 7 publications

References 10 publications

Endemic and Other Dimorphic Mycoses in The Americas

Endemic and Other Dimorphic Mycoses in The Americas

Blastomycosis

Current and New Perspectives in the Diagnosis of Blastomycosis and Histoplasmosis

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