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
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.
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
Extremities
- Ulcers