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At least 199 records · Page 11Linked to original sources
PubMed1987

Use of a urease-antibody conjugate in an enzyme immunoassay for the detection of blastomycosis.

A urease-antibody conjugate was used in an enzyme-linked immunoassay (ELISA) for the detection of antibodies in blastomycosis. A Blastomyces dermatitidis immunodiffusion antigen was used as the reference antigen in a solid phase indirect ELISA procedure and the endpoints were determined visually. Urease ELISA results on serum specimens from patients with blastomycosis compared favorably (90%) with results obtained spectrophotometrically by the alkaline phosphatase enzyme system. Specificity was evaluated with assays on sera from patients with histoplasmosis (20% cross reactivity), coccidioidomycosis (0% cross reactivity) and on Histoplasma capsulatum skin-test positive individuals (0% cross reactivity). The ease of performance of the urease ELISA combined with no requirements for specialized spectrophometric equipment are factors that favor the continued development of the test as an alternative serodiagnostic method. The assay may prove to be useful and a valuable adjunct to fungal antibody screening procedures.

Antibodies, Fungal↗
PubMed1988

Experimental blastomycosis pneumonia in mice by infection with conidia.

We describe a murine model of acute blastomycosis pneumonia induced by Blastomyces dermatitidis conidia. Anesthetized mice were infected by placing a droplet containing conidia suspended in sterile saline on the nares and allowing the suspension to be aspirated into the lungs. Conidia were obtained from mycelia derived from the yeast forms of two well characterized strains of B. dermatitidis, ATCC 26199 and 26197. ATCC 26199 yeast and conidia were highly virulent in BALB/cByJ mice whereas both forms of ATCC 26197 were incapable of causing disease in 60 days. Conidia and yeasts of the virulent strain caused pathologic changes primarily in the lungs, whereas no abnormalities were seen in the lungs, or elsewhere, in mice infected with the a virulent strain. Small numbers of ATCC 26199 yeast forms were found in scattered foci in liver and kidneys, but no inflammatory reaction surrounded the fungus. This murine model of acute blastomycosis pneumonia mimics the acute disease in humans and is initiated with the naturally infectious particle.

Animals↗
PubMed2006

Susceptibility to pulmonary blastomycosis in young compared to adult mice: immune deficiencies in young mice.

The immunological basis for differences in resistance to pulmonary blastomycosis between young (3 to 4-week-old) and adult (7 to 8-week-old) CD-1 mice is unknown. We assessed whether there were differences in fungicidal activity of phagocytes and Th-1 lymphocyte cytokine production. The fungicidal activity of young bronchoalveolar macrophages (BAM) (20%) against Blastomyces dermatitidis (Bd) was comparable to killing by adult BAM (25%). However, IFN-gamma enhanced the killing by adult BAM (from 30 to 69%) to a greater extent than BAM from young animals (from 20 to 30%). Killing of Bd by young peritoneal macrophages (PM) (46%) and adult PM (42%) was similar, and the enhancement of cells of both by IFN-gamma was similar. TNFalpha production by young macrophages (BAM or PM), when cocultured with Bd for 18 h, was half of TNFalpha secreted by adult macrophages. We found that polymorphonuclear neutrophils (PMN) from young mice had deficient fungicidal activity against Bd (37%) compared with adult PMN (80%). Interferon-gamma (IFN-gamma) treatment increased PMN killing of Bd by PMN of young animals from 37 to 80%. In an assessment of innate responses, we found spleen cells from young mice produced three-fold less IFN-gamma and three-fold less IL-2 than adult spleen cells in response to 1 microg/ml concanavalin A (Con A). The young spleen cells also produced more NO, which we demonstrated reduced Con A-induced proliferation. These in vitro results demonstrate several immunological deficiencies in cells from young mice and these deficiencies correlate with susceptibility. In a pilot reconstitution experiment in pulmonary blastomycosis, treatment of infected young mice with IFN-gamma (18.5 x 10(3) U, s.c.) on days 0, 1, and 2 significantly increased survival.

Age Factors↗
PubMed2005

Successful treatment of cerebral blastomycosis with voriconazole.

Blastomycosis can occasionally involve the central nervous system (CNS). Amphotericin B deoxycholate is considered the drug of choice for the treatment of CNS blastomycosis. Significant toxicity may be associated with its use. We describe a case of cerebral blastomycoma that was successfully treated with voriconazole.

Antifungal Agents↗
PubMed1984

Cerebral blastomycosis: an immunodiagnostic study.

Cerebral blastomycosis may simulate a brain tumor. Its diagnosis is sometimes very difficult. The morphologic identification of the fungus may be misleading because it shares some common features with many other dimorphic fungi. Culturing and conversion of the organism from mycelial phase to yeast phase are not always successful. Immunofluorescent staining of the biopsy tissue is useful in confirming the diagnosis. However, a combination of double immunodiffusion (DID) test and complement fixation (CF) test makes the diagnosis more accurate and reliable. The direct role of macrophages in defending the host against blastomycosis is illustrated by electron microscopy.

Antigens, Fungal↗
PubMed1990

Giant forms of Blastomyces dermatitidis in the pulmonary lesions of blastomycosis. Potential confusion with Coccidioides immitis.

Typical yeast-phase cells of Blastomyces dermatitidis have a characteristic appearance in tissue sections. Fungal morphologic variation occurs infrequently in the lesions of blastomycosis, yet it can complicate the differential diagnosis, particularly if fresh tissue is not available for microbiologic culture. The authors report a case of pulmonary blastomycosis, confirmed by culture and direct immunofluorescence, in which some of the yeast-like cells were abnormally large. These giant yeast-like cells exceeded the size range accepted for the tissue forms of B. dermatitidis; therefore, coccidioidomycosis was considered initially in the differential diagnosis. Otherwise characteristic morphologic features of these cells, in particular multinucleation and the production of broad-based blastoconidia, helped resolve the differential diagnosis. The diagnosis can be confirmed by direct immunofluorescence or microbiologic culture.

Blastomyces↗
PubMedDate not supplied

An outbreak of human and canine blastomycosis.

In the summer and fall of 1988, three humans and one dog in a lakeshore community in northern Wisconsin were found to have blastomycosis on the basis of the results of cultures and histologic studies; the infection was also suspected in one human and four dogs on the basis of clinical data. Serologic testing with use of enzyme immunoassay for antibody to the A antigen of Blastomyces dermatitidis was performed for 77 additional human residents and visitors in the area an average of 9 months after the outbreak. Titers of antibody of greater than or equal to 1:32 were considered presumptive evidence of blastomycosis, and measurement of such titers enabled identification of 18 additional suspected cases in this group, compared with none in a control group (n = 40). Of the 22 humans with confirmed and suspected cases, 16 (73%) were asymptomatic. Epidemiologic and meteorologic data gathered during this period suggested an associated between this outbreak and the presence of dust from excavation for a hotel across the lake. The result of this study further confirm the common occurrence of self-limited and subclinical infection with B. dermatitidis and suggest that excavation in an area endemic for B. dermatitidis is a risk factor for human and canine infection.

Adolescent↗
PubMed1993

Blastomycosis in transplant recipients: report of a case and review.

Fungi cause serious, often fatal infections in immunocompromised hosts. Recipients of solid organ and bone marrow transplants are predisposed to invasive fungal infections with Candida species, Aspergillus species, and Cryptococcus neoformans. In contrast, infections with Blastomyces dermatitidis have rarely been diagnosed in transplant recipients. We describe a patient who received an orthotopic heart transplant and developed recurrent disseminated blastomycosis. Other reported cases of blastomycosis in transplant recipients are summarized. Clinical presentation, treatment options, and morbidity associated with infections with B. dermatitidis in transplant patients are reviewed.

Amphotericin B↗
PubMed1996

Histoplasmosis and blastomycosis.

Histoplasmosis and blastomycosis are caused by dimorphic fungi, can be epidemic or endemic, and can produce a spectrum of illness, from subclinical infection to progressive disseminated disease. Diagnosis of both is best made by visualization of yeast in tissue or by culture. Itraconazole is the drug of choice for treatment of both histoplasmosis and blastomycosis, except in cases of life-threatening infection, for which amphotericin B is indicated. A heavy inoculum of Histoplasma capsulatum may cause acute pulmonary infection in an otherwise healthy host, resulting in fever, hypoxia, and pulmonary infiltrates. Opportunistic histoplasmosis develops as chronic pulmonary histoplasmosis in those with a structural defect in the lung (emphysema) or as disseminated histoplasmosis in patients with cellular immune deficiency (due to immunosuppressants or AIDS). Blastomyces dermatitidis causes both pulmonary and extrapulmonary disease. Lung involvement may mimic bacterial pneumonia, while chronic presentations mimic lung cancer or tuberculosis. Skin is the most common extrapulmonary site of disease, followed by bone, prostate, and central nervous system.

AIDS-Related Opportunistic Infections↗
PubMed1987

Serological tests for blastomycosis: assessments during a large point-source outbreak in Wisconsin.

Enzyme immunoassay (EIA), immunodiffusion (ID), and complement fixation (CF) tests for antibody to the A antigen of Blastomyces dermatitidis were assessed in 47 patients in an epidemic of blastomycosis and in 89 control subjects with lower respiratory tract illness. Antibody was detected by EIA, ID, and CF in 77%, 28%, and 9% of the patients, respectively. EIA titers ranged from 1:8-1:512 (median titer, 1:128). Antibody detected by ID or CF was always detectable by EIA. Antibody was detected by EIA 13 days after illness onset, and the peak seroprevalence rate and geometric mean titer occurred 50-70 days after onset. Antifungal therapy produced a significant decline in antibody titer by approximately six months after onset. Seven (8%) control subjects had detectable antibody, six had EIA titers of 1:8, and one had a titer of 1:16. The specificities for EIA, ID, and CF were 92%, 100%, and 100%, respectively. The EIA provides a significant advance in serodiagnostic testing for blastomycosis and can be used in an outbreak setting as an epidemiological tool to identify acute B. dermatitidis infection; titers greater than or equal to 1:32 strongly support the diagnosis, whereas titers of 1:8 or 1:16 are suggestive.

Adult↗
PubMed1991

Two cases of blastomycosis from a common source: use of DNA restriction analysis to identify strains.

Two friends, one with AIDS, developed severe pulmonary blastomycosis but differed markedly in clinical course. The human immunodeficiency virus-negative patient responded completely to ketoconazole; the patient with AIDS died of progressive disseminated infection despite treatment with fluconazole and amphotericin B. Epidemiologic investigation suggested a common source of infection, but serologic evaluation and environmental cultures were unrevealing. EcoRI digestion of the Blastomyces dermatitidis isolates showed identical restriction fragment patterns that differed from patterns obtained from other clinical isolates. Analysis using a Histoplasma capsulatum ribosomal DNA probe that cross-hybridizes with B. dermatitidis showed that the isolates from the two patients were identical and different from others. Thus, the patients were probably infected with the same strain, possibly from a common source. These data indicate the critical role of cellular immunity in patients with blastomycosis, show that there are multiple genotypes of B. dermatitidis, and suggest that DNA restriction analysis is a useful epidemiologic tool.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Blastomycosis in Washington Parish, Louisiana, 1976-1985.

For the period 1976-1985, the authors attempted to identify all cases of blastomycosis in Louisiana and studied in detail one county (Washington Parish) suspected by local physicians of having an unusually high incidence of the disease. The mean annual incidence rates for Louisiana and for Washington Parish were 0.23 and 6.8 cases per 100,000 population, respectively. To the authors' knowledge, the rate for Washington Parish is the highest annual incidence rate documented for a population in a nonoutbreak setting. Among the 30 cases detected in Washington Parish, the age range was 3 weeks to 81 years. Five cases died; of these, one was an infant who may have been infected in utero, and another developed clinical symptoms compatible with adult respiratory distress syndrome. There was no geographic clustering among cases the authors investigated, and a case-control study failed to identify specific activities or host factors which may have predispose to infection. Washington Parish is probably a hyperendemic area for blastomycosis because environmental conditions are especially conducive to Blastomyces dermatitidis growth. The study suggests that most cases in Washington Parish were sporadically infected, and common-source exposures to B. dermatitidis with resultant clinical illness are rare even in hyperendemic settings.

Adolescent↗
PubMed1992

Case report: treatment of blastomycosis with fluconazole.

The authors present two cases of systemic blastomycosis successfully treated with fluconazole. In one case, the disease involved the respiratory tract, and the central nervous system was presumed to be involved. The second case consisted only of pulmonary blastomycosis. Both patients were treated with oral fluconazole 200 mg twice per day for 9 and 6 months, respectively. Treatment with this new triazole antifungal agent resulted in the complete resolution of the disease in both patients. They have remained asymptomatic for more than 6 months after the completion of therapy.

Adult↗
PubMed1994

Blastomycosis infection of the hand.

Blastomycosis is an uncommon cause of infection in the hand. Fungal infection should be suspected in any case when expected improvement does not occur with appropriate antibiotic therapy and wound care. We describe a rare case of primary blastomycosis of the hand that progressed to severe soft tissue destruction and significant loss of hand function.

Aged↗
PubMed1992

Blastomycosis of the eyelid and conjunctiva.

A 37-year-old man with a recurrent papillomatous lesion of the upper eyelid and four separate bulbar conjunctival ulcers was found to have North American blastomycosis. This represents the first reported case with conjunctival lesions that were not simply contiguous with eyelid involvement. This case underscores the importance of considering blastomycosis in the differential diagnosis of granulomatous conjunctivitis and when examining a lesion of the eyelid resembling a squamous cell carcinoma or atypical papilloma.

Adult↗
PubMed1977

Addison's disease secondary to North American blastomycosis.

Reported is the fifth known case of Addison's disease due to adrenal involvement by North American blastomycosis (Blastomyces dermatitidis infection). The fact that amphotericin B therapy precipitated an addisonian crisis suggests that patients with disseminated blastomycosis should have their adrenal function and reserve evaluated before undergoing systemic chemotherapy.

Addison Disease↗
PubMed1978

Blastomycosis of fronto-ethmoid complex.

Blastomycosis in children is relatively infrequent. Further, osteomyelitis of the frontal bone, which prior to the antibiotic era occurred more frequently and was mostly due to pyogenic cocci, is rare today. We described a case of frontal osteomyelitis in a child due to blastomycosis which occurred in the absence of frontal sinuses. To our knowledge this rare combination of factors has not previously been reported.

Blastomycosis↗
PubMed1986

Disseminated blastomycosis treated with ketoconazole.

A patient with disseminated blastomycosis gave birth to an infant who died three weeks later of diffuse pulmonary blastomycosis. The infant most likely acquired the disease through intrauterine transmission. The patient's extensive skin lesions responded dramatically to ketoconazole.

Blastomycosis↗