Blastomycosis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]
Overview
Transmission
- Inhalation of the fungus from its natural soil habitat is considered the most significant route of transmission.
- Other less common route of transmission is by cutaneous inoculation through direct skin injury.
Incubation
- The incubation period varies from 3 weeks to 3 months after exposure.
Pathogensis
- Once inhaled in the lungs, the conidia are mostly destroyed due to their susceptibility to neutrophils, leukocytes and macrophages.
- However, a few conidia escape this protective mechanism and evolve into yeast form, which being double walled structures are more resistant to destruction.
- This conversion releases a glycoprotien BAD-1, which induces cell mediated immunity.
- This results in a pyogranulomatous response at the site of infection (lungs).
- Which eventually leads to the formation of a non-caseating granulomas.
Dissemination
- The fungi multiply in the primary foci and can get disseminate through the blood and lymphatics to other organs, including the skin, bone, genitourinary tract.
