Blastomycosis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2], Vidit Bhargava, M.B.B.S [3]
Overview
The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are : lungs, skin, bones, genitourinary system, central nervous system and other misc organs.
Physical Examination
Vital Signs
- Fever
- Tachypnea
Oral cavity
- Oral ulcers can be seen in some patients
Gallery
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Nodular skin lesions of blastomycosis, one of which is a bullous lesion on top of a nodule. From Public Health Image Library (PHIL). [1]
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Fungal infection of the face affecting his right eye, upper lip, nares, and tongue. Brazilian blastomycosis, is caused by the fungal organism, Paracoccidioides brasiliensis. From Public Health Image Library (PHIL). [1]
Lungs
Findings consistent with parenchymal consolidation such as
- dullness to percussion
- increased fremitus
- Signs of pleura involvement such as pleuritic rub can be found.
Skin
- Ulcerative lesions that bleed easily
- Verrucous lesions with irregular border and variegated appearance
- In cases with skin involvement from inoculation regional lymph node enlargement may be seen.
Bone and joints
- Soft tissue swelling around the area of involvement and discharging sinuses might be consistent with osteomyelitis.
- Arthritis can cause reproducible pain in joints.
Genitourinary system
- Pyuria
- Painful urination