B is for Blastomycosis

Blastomycosis budding yeast on histopathology sample (www.cdc.gov/blastomycosis)

Blastomycosis

(Blastomyces dermatitidis)

 the Big Blue Broad-based Budding Yeast

Blastomycosis (aka Blasto) is a fungus that lives in soil, usually along waterways. It is found through the Americas and is most common in the United States in the Mississippi and Ohio River Valleys. A hot bed of blastomycosis in Wisconsin is actually in Eagle River, Wisconsin, so be careful if traveling! The infection is caused by spores from the fungus getting into airways or breaks in the skin. Dogs are the most often effected by blasto and it can cause respiratory issues (most often due to inhaling of spores while sniffing around rivers) as well as cutaneous (skin) and ocular (eye) manifestations, in severe cases it can also spread to other internal organs and the brain. Only about 50% of people that are infected actually show symptoms – these people are usually immune-compromised,

Symptoms are generally flu-like – fever, chills, chest pain/discomfort, swollen joints, and most often a cough.

Diagnosis is usually through observation of the yeast in samples or through urine tests. Blood tests are not very reliable and culturing (growing the yeast in the lab) from samples is very dangerous to those handling the samples.

Treatment consists of anti-fungal medications and controlling symptoms.

 I have treated many animals with blastomycosis. They can be difficult cases, but can be very rewarding when you beat the disease! One of the most memorable cases that have come through my office was actually a dog that we checked for blasto, but she did not have it. Sadly, her owner did. The owner was initially diagnosed with pneumonia and was placed on steroids. Unfortunately, steroids make fungal infections, like blastomycosis, significantly worse. The gentleman was placed on life support because the steroids caused the blastomycosis to spread to his lungs, liver, kidneys, and brain. While speaking with his son when he brought the dog in for testing, we discussed his father’s situation. His father was transferred to another hospital and was properly diagnosed with blastomycosis and appropriate treatment was started. The joy is that with proper treatment, he was able to get off of the ventilator and survived. Life will never be perfect for him, but he is OK. I have lost track of him as I have moved over time, but I am happy to know that he survived!

A to Z 2014