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The dimorphic fungus, Blastomyces dermatitidis, causes blastomycosis. When the organism is inhaled, it causes pulmonary disease - cough, pain, and hemoptysis, along with fever and night sweats. It commonly spreads to the skin, bone, or internal genitalia where suppuration and granulomas are typical. Occasionally, primary cutaneous lesions after trauma are encountered; however, this type of infection is uncommon.
Detection of antibodies in patients having blastomycosis
A positive result is suggestive of infection, but the results cannot distinguish between active disease and prior exposure.
Routine culture of clinical specimens (eg, respiratory specimen) is recommended in cases of suspected, active blastomycosis.
The Mayo experience with the immunodiffusion test is that it is positive in fewer cases of blastomycosis than the 70% to 85% reported elsewhere.
Patients with histoplasmosis may have low-titered cross reactions.
Kaufman L, Kovacs JA, Reiss E: Clinical Immunomycology. In Manual of Clinical and Laboratory Immunology. Edited by NL Rose, E Conway-de Macario, JD Folds, et al. Washington, DC, ASM Press, 1997, pp 588-589