Over the last 10 years, there has been an increase in a lesser-known lung infection called blastomycosis. This disease is rare and mostly affects those who are involved in outdoor activities, as the fungus Blastomyces dermatitidis, is found in moist soil of rotting plants, leaves or wood. People can get blastomycosis by disturbing infected soil or plants, which releases tiny spores into the air. Breathing in these fungal spores may cause a lung infection which, if not treated, sometimes spreads to other parts of the body.
Who is most at risk?
Anyone can get blastomycosis, however, of the people who breathe in Blastomyces spores many don’t get sick. Others will go on to develop a respiratory infection that, if untreated, can become serious. People in certain jobs, like outdoor construction, forestry work, or laboratory scientists are at higher risk of encountering Blastomyces. Anyone who frequently participates in outdoor activities, like hunting and camping, may also be a higher risk.
Blastomycosis is more likely to infect those who have weakened immune systems. This includes anyone with HIV/AIDS, anyone who has had an organ transplant, anyone who is taking corticosteroids or TNF w -inhibitors and during pregnancy. However, blastomycosis can also make people with immune systems that are functioning correctly seriously ill.
What are symptoms of Blastomycosis?
About half of people infected with Blastomyces experience symptoms of blastomycosis which may occur between three to 15 weeks from exposure. Symptoms include fever, cough, shortness of breath, weight loss, body aches, chest pain, fatigue and night sweats. If the infection spreads beyond the lungs you may also develop a rash, blisters or ulcers on your skin. In severe cases, blastomycosis may also spread to the bones, joints, brain and spinal cord.
People who are immunocompromised are most at risk of severe infection, as for these people blastomycosis may spread from the lungs to other parts of the body. Bones and joint problems or problems with the central nervous system (the brain and spinal cord), are all possible.
How are you diagnosed and treated for Blastomycosis?
In addition to a physical exam, your healthcare provider will obtain a medical and travel history. It is important to share activities you engage in at work and recreationally to help your provider know if you have had a possible exposure.
If you have been in an area where the fungus lives, mostly in the central and southeastern United States and parts of Canada, and have pneumonia that is not responding to antibiotics, you may be tested for blastomycosis. Blood or urine test will be sent to the laboratory for analysis. A chest x-ray or CT scan may be ordered, and bronchoscopy may be needed to collect sputum/phlegm or tissue samples.
If any of the tests come back positive, your healthcare provider will recommend antifungal medication to treat the infection and prevent blastomycosis from spreading beyond the lungs. The type of antifungal medication you are given will depend on the severity of symptoms. For mild to moderate infections, itraconazole is commonly prescribed. For more severe cases, an IV drug called Amphotericin B will be given. The length of treatment, from six months to a year, will also depend on how severe the infection is or if you are immunocompromised.
For most people, this treatment will allow them to recover fully, however, without treatment blastomycosis can be deadly. Due to the potential severity of this disease, if you suspect you may have contracted blastomycosis, it is important that you talk to your healthcare provider.
Blog last updated: January 26, 2024
