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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. Central nervous system disease 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. Furthermore, detection of antibodies in cerebrospinal fluid (CSF) may reflect intrathecal antibody production, or may occur due to passive transfer or introduction of antibodies from the blood during lumbar puncture.
Routine fungal culture of clinical specimens (eg, CSF) is recommended in cases of suspected blastomycosis involving the central nervous system.
A negative result does not rule out blastomycosis.
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, American Society for Microbiology, 1997, pp 588-589