Disseminated Blastomycosis in an Immunocompetent Patient

Abstract

Blastomycosis is caused by Blastomyces dermatitidis, which is endemic in certain areas in North America. It usually causes lung infection, and it can disseminate to other organs in immunocompromised individuals. Common sites for dissemination include skin, central nervous system (CNS), and bone. Dermatological spread is the commonest site for extrapulmonary spread. The diagnosis can be easily missed due to nonspecific presentation and variable dermatological presentations. Treatment is necessary even if the patient has improvement in symptoms without previous treatment. We present a case of disseminated blastomycosis in a 40-year-old male without known risk factors that went undiagnosed for over a year.

Keywords: blastomycosis diagnosis; cutaneous fungal infections; disseminated blastomycosis; fungal infection; pulmonary blastomycosis; skin blastomycosis.

Figure 1. Right hand wart-like lesions.

Figure 2. Forehead wart-like lesion.

Figure 3. Left foot lesions.