Blastomycosis: photos, symptoms, pathogen, treatment, causes

August 25, 2017 23:00 | Mycosis

Blastomycosis is represented by one of the infections that are in the group of systemic mycoses.With this disease, lung damage( primary), hematogenous dissemination of the fungus inside the bone tissue, internal organs, epithelium occurs.This pathology affects people in different forms( genitourinary, skin, bone, pulmonary).Therapy most often involves the use of antifungal agents.This article will tell you in detail about the pathogens of blastomycosis, its treatment, its causes and complications.

Features of the disease

The peculiarity of this fungal disease is that infection begins from the beginning of the epithelium, the lungs. Over time, the fungus spreads to the entire body, in tissues affected by fungus, ulcerous defects occur, a purulent process begins.

The disease most often affects the following organs:

  • liver;
  • genitals;
  • prostate gland;
  • adrenal glands;
  • bone system;
  • meninges.

Risk groups

blastomycosis People at risk are those who:

  • hypothyroidism;
  • diabetes mellitus;
  • immunodeficiency caused by various causes( recovery after transplantation, HIV infection, chemotherapy therapy);
  • sarcoidosis;
  • chronic diseases in a state of decompensation;
  • tuberculosis.

In addition to people with weak immunity, the following groups are at risk:

  • tourists;
  • farmers;
  • anglers;
  • agricultural workers;
  • mushroom pickers;
  • hunters;
  • population living in an endemic area for blastomycosis.

Classification

Given the nature of the disease, experts identified the following types:

  • acute;
  • chronic.

If the classification is based on the course of the disease, the specialists distinguish 3 types of blastomycosis:

  1. Light degree of severity.
  2. Medium severity.
  3. Heavy.

Given the defeat of organs, the scientist distinguishes 2 types of ailment:

  1. Pulmonary.
  2. Disseminated.

In addition to the above types, the following are also distinguished:

  • European;
  • is keloid;
  • North American;
  • South American.

According to the International Classification of Diseases, we are considering the disease given the seven codes:

code in ICD-10 Disease name
V40.0 Pulmonary blastomycosis( acute)
V40.1 pulmonary blastomycosis( chronic)
V40.2 pulmonary blastomycosis( unspecified)
V40.3 Cutaneous blastomycosis
V40.7 Disseminated blastomycosis
V40.8 Other blastomycosis
V40.9 Blastomycosis unspecified

Causes

This dangerous fungal disease is widespread.The largest number of fungi live in North America, in Africa.Wet conditions in the environment are considered ideal conditions for its reproduction.Therefore, the fungus is more often localized near lakes, reservoirs, large river basins.

The most common type of infection, North American blastomycosis, is caused by a fungus found in the soil( Blastonyces dermatitidi).This fungus penetrates the body through the respiratory tract with dust, in which there are spores of the fungus.Distribution of fungal spores throughout the body occurs in two ways:

  1. Hematogenous.
  2. Lymphogenous.

There is our fungus in such forms:

  • Mycelial .In it, the fungus stays at t below 300 ° C;
  • Yeast form .In it the fungus parasitizes inside the body at t above 370С.

Once inside the respiratory organs, the infection forms foci of inflammation, which soon cause granulomas, suppuration, necrosis.Damage to the dermis, internal organs occurs after the fungus is located inside the lungs, and spread through the body through blood, lymph.

Blastomycosis North American( photo)

Blastomikoz-severoamerikanskij-foto

Symptoms of blastomycosis

The scientists identified the most popular clinical forms of this pathology:

  • pulmonary;
  • genitourinary;
  • cutaneous;
  • bone.

Also less common is fungal infection of the liver, thyroid gland, central nervous system, adrenal glands, spleen, pericardium.A feature of the disseminated species is the fact that the fungal lesion develops only a few years after it has affected the lungs.

Pulmonary form

The pulmonary form of the disease is considered to be the most frequent.It accounts for about 60 - 90% of all cases.The incubation period lasts 30-45 days.This form proceeds like bronchopneumonia, it is characterized by a fairly sharp beginning.The main signs of the development of the disease are signs of intoxication:

  • chills;
  • muscle pain;
  • tenderness of the joints;
  • temperature( low-grade / febrile).

Much less often the disease develops as a primary chronic disease, without the presence of vivid signs.In this case, the patient exhibits such symptoms:

  • cough( dry initially, with purulent sputum after a while);
  • shortness of breath;
  • chest pain;
  • hemoptysis.

When examined, a specialist listens to wheezing, pleural friction noise.

Cutaneous form

The second most frequent form of the disease is blastomycosis of the skin.It accounts for 40 - 80% of cases.This pathology is characterized by:

  • Presence of rashes( papular-pustular, vesicular-papular);
  • ulcerative formations;
  • granulation on ulcers;
  • spread of ulcers on the pharyngeal mucosa, oral cavity, larynx;
  • the formation of abscesses under the epidermis.

Bone and genitourinary forms

Blastomycosis The third most common bone form.Its part of the total cases of the disease is only 25 - 50%.This type of ailment is characterized by symptoms of osteomyelitis.In the area of ​​lesions arise:

  • abscesses of soft tissues;
  • fistulous passage;
  • joint arthritis.

Then comes the urogenital form, which is more often diagnosed in men( 10 - 30% of cases).Symptoms are similar to epididymitis, prostatitis, orchitis.A woman is infected by this form through sexual contact.In the fair sex, this pathology is considered very rare.

Diagnosis

Doctors

Many experts are involved in the diagnosis:

  • urologist;
  • dermatologist;
  • mycologist;
  • pulmonary specialist;
  • infectious disease.

Methods

Often, people from endemic areas who complain of inflammation of the dermis, urogenital system, lungs, bones seek help.The diagnosis is confirmed when B. dermatitidi is found in the biological material of the patient( urine, cerebrospinal fluid, pus, sputum, biopsy material).

As the diagnostic methods, the most commonly used are:

  • serological studies( RIF, PCR);
  • biochemical studies;
  • blood glucose;
  • bronchoscopy;
  • osteoscintigraphy;
  • blood test, urine( general);
  • puncture of abscess( for taking material);
  • puncture of cerebrospinal fluid;CTD20ASD
  • CT of the spine, brain;
  • microbiological seeding;
  • microscopic examination;
  • chest radiography.

Differential diagnostics

It is also necessary to differentiate the diagnosis of the pulmonary form of the disease with the following pathologies:

  • tuberculosis;
  • aspergillosis( pulmonary form);
  • pleural empyema;
  • bacterial pneumonia;
  • neoplasm in the lungs;
  • lung abscess.

Diagnosis is needed to differentiate the cutaneous form of the disease from:

  • of dermatomycoses;
  • pyoderma;
  • squamous cell carcinoma.

The bony form is differentiated from:

  • of bacterial osteomyelitis;
  • of bone tuberculosis.

The disease is differentiated from:

  • prostate cancer;
  • of syphilis;
  • of bacterial prostatitis;
  • orcoepidymitis.

Treatment

blastomycosis The treatment of fungal disease should be taken seriously. Without appropriate therapy alone, only acute pulmonary blastomycosis can pass. All other forms of the disease require special antifungal therapy.

Medical method

Therapy of this fungal disease is carried out by means of such preparations:

  • Antibacterial( protected penicillins, fluoroquinolones, macrolides, cephalosporins).
  • Antihistamines( "Tsetril", "Suprastin").
  • Painkillers( Ketoprofen, Omnopon, Morphine).
  • Antipyretics( "Ibuprofen", "Paracetamol").
  • Antiseptics( Miramistin, Chlorhexidine).
  • Anticonvulsant( "Fenlipsin").
  • Group B vitamins.
  • Diuretics( Furosemide, Torasemide).
  • Glucocorticosteroids.

About the drug Sporagal, which also helps against blastomycosis, will tell this video:

Operation

In some cases, it may be necessary to drain the skin abscesses, excising the necrotic dermis.If the lungs have accumulated purulent exudate, you need to drain the pleural cavity.

Prevention of the disease

Preventive measures are very simple, they are:

  1. Compliance with personal hygiene.
  2. Use of contraceptives( barrier).
  3. Timely, correct treatment of injuries of the dermis.

If possible, avoid trips to endemic blastomycosis regions.

Complications

The fungal disease of blastomycosis has many complications that manifest itself without properly selected, timely therapy:

  • acute renal failure;
  • anemia;
  • arthritis;
  • pneumonia;
  • brain abscess;
  • acute urine retention;
  • acute pulmonary disease;
  • osteomyelitis;
  • prostatitis.

Forecast

Blastomycosis The disease can be cured if the diagnosis is carried out in a timely manner, the correct therapy. In this case, blastomycosis passes without any consequences for the body.

Fungus recurs in 10% of cases.If you do not start proper treatment in time, a lethal outcome is possible( 80 - 95% of cases).