Blastomycosis differential diagnosis: Difference between revisions
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====Fungal==== | ====Fungal==== | ||
* [[Coccidioidomycosis]] | * [[Coccidioidomycosis]] | ||
* [[Histoplasmosis]] | * [[Histoplasmosis]] | ||
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{| class="wikitable" | {| class="wikitable" | ||
!Disease | !Disease | ||
! | !Geographic distribution | ||
!High risk Groups | |||
!Differentiating Features | !Differentiating Features | ||
! | !Microscopic findings | ||
!Differentiating Laboratory findings | !Differentiating Laboratory findings | ||
|- | |- | ||
|[[Histoplasmosis]] | |[[Histoplasmosis]] | ||
|Mississippi and Ohio River valleys | |Mississippi and Ohio River valleys | ||
|Palate and oral ulcers | | | ||
| | * Cave dwellers | ||
* Soil that contains bird or bat dropping | |||
| | |||
* Palate and oral ulcers | |||
* Spleenomegaly | |||
|Yeast are typically smaller, with narrow-based budding, found intracellularly within macrophages | |||
|Pancytopenia | |Pancytopenia | ||
Urine antigen testing | Urine antigen testing | ||
| Line 62: | Line 67: | ||
|Southwestern US region | |Southwestern US region | ||
|Opportunistic infection seen in AIDS | |Opportunistic infection seen in AIDS | ||
| | |||
* Rash on upper body or legs | |||
* Night sweats | |||
|Characteristic spherule appearance | |Characteristic spherule appearance | ||
|Serologic tests( enzyme immune assay )more sensitive | |Serologic tests( enzyme immune assay )more sensitive | ||
| Line 67: | Line 75: | ||
|[[Paracoccidioidomycosis]] | |[[Paracoccidioidomycosis]] | ||
|Central and South america | |Central and South america | ||
|Lymphadenopathy | |Opportunistic infection seen in AIDS | ||
Hepatosplenomegaly | | | ||
* Lymphadenopathy | |||
Bone marrow dysfunction | * Hepatosplenomegaly | ||
* Bone marrow dysfunction | |||
|Smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.( Captain wheel appearance ) | |Smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.( Captain wheel appearance ) | ||
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|- | |- | ||
|[[Sporotrichosis]] | |[[Sporotrichosis]] | ||
|Ubiquitous | |||
|Gardeners | |||
| | |||
* Person’s hand or the arm | |||
* Lymphadenitis (nodular) | |||
|Finger or cigar shaped yeast. | |||
|Sporotrichin skin test | |||
|- | |||
|[[Aspergillosis]] | |||
|Ubiquitous | |||
| | | | ||
* Cystic fibrosis or asthma. tuberculosis. | |||
* Immunocomprimised | |||
| | | | ||
| | * Wheezing | ||
* Stuffiness, runny nose | |||
* Hemoptysis | |||
* Weight loss | |||
|Septated hyphae with acute angle branching | |||
|Cell wall detection using galactomannan antigen detection, Beta-D-glucan detection test. | |||
|- | |- | ||
|[[Tuberculosis|Pulmonary Tuberculosis]] | |[[Tuberculosis|Pulmonary Tuberculosis]] | ||
| | |||
| | | | ||
|No cutaneous involvement | |No cutaneous involvement | ||
|Acid fast bacteria | |Acid fast bacteria | ||
| | | | ||
|- | |- | ||
|[[Nocardiosis]] | |[[Nocardiosis]] | ||
| | |||
| | | | ||
|Immunocompromised people | |Immunocompromised people | ||
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|} | |} | ||
== | ==iReferences== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:32, 1 March 2017
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Blastomycosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Blastomycosis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Blastomycosis differential diagnosis |
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Risk calculators and risk factors for Blastomycosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2] Aditya Ganti M.B.B.S. [3]
Overview
Acute pneumonia itself is a mild flu-like illness that needs to be differentiated from a number of other fungal/bacterial disorders. These disorders have overlapping signs & symptoms that often need detailed History, Physical examination and serological tests to pin-point the diagnosis. It can be often misinterpreted as community acquired pneumonia.
Fungal
Bacterial
- Anthrax
- Legionella
- Listeriosis
- Brucellosis
- Tuberculosis
- Scrub typhus
- Leptospirosis
- Cat scratch fever
Viral
- Chickenpox
- Herpes(Prodrome)
- Influenza
- Parainfluenza
- HIV -1/-2
- Coxsackie B virus
- Hepatits
- Cytomegalovirus
- Eastern equine encephalitis virus
- Venezuelan equine encephalitis
- Coronavirus
- California Encephalitis virus
Chronic and disseminated disease
Chronic blastomycosis may be initially confused with a malignancy or tuberculosis. While spread to other areas may be confused with malignancy as well. Skin lesions are often misdiagnosed as pyoderma gangreosum or keratoacanthoma. Therefore, a high index of suspicion is needed on the part of physician to diagnose blastomycosis
| Disease | Geographic distribution | High risk Groups | Differentiating Features | Microscopic findings | Differentiating Laboratory findings |
|---|---|---|---|---|---|
| Histoplasmosis | Mississippi and Ohio River valleys |
|
|
Yeast are typically smaller, with narrow-based budding, found intracellularly within macrophages | Pancytopenia
Urine antigen testing |
| Coccidioidomycosis | Southwestern US region | Opportunistic infection seen in AIDS |
|
Characteristic spherule appearance | Serologic tests( enzyme immune assay )more sensitive |
| Paracoccidioidomycosis | Central and South america | Opportunistic infection seen in AIDS |
|
Smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.( Captain wheel appearance ) | |
| Sporotrichosis | Ubiquitous | Gardeners |
|
Finger or cigar shaped yeast. | Sporotrichin skin test |
| Aspergillosis | Ubiquitous |
|
|
Septated hyphae with acute angle branching | Cell wall detection using galactomannan antigen detection, Beta-D-glucan detection test. |
| Pulmonary Tuberculosis | No cutaneous involvement | Acid fast bacteria | |||
| Nocardiosis | Immunocompromised people
worldwide distribution |
Microscopic examination ; thin, branching gram-positive bacilli
acid fast positive |