Blastomycosis differential diagnosis

Blastomycosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Blastomycosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Blastomycosis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Blastomycosis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Blastomycosis differential diagnosis
CDC on Blastomycosis differential diagnosis
Blastomycosis differential diagnosis in the news
Blogs on Blastomycosis differential diagnosis
Directions to Hospitals Treating Blastomycosis
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

• Coccidioidomycosis
• Histoplasmosis
• Aspergillosis
• Pneumocystis pneumonia
• Sporotrichosis

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	Geophraphic distrubution	Differentiating Features	Culture findings	Differentiating Laboratory findings
Histoplasmosis	Mississippi and Ohio River valleys	Palate and oral ulcers spleenomegaly	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	Lymphadenopathy, Hepatosplenomegaly, Bone marrow dysfunction	Smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.( Captain wheel appearance )
Sporotrichosis		Gardeners are at high risk Lymphadenitis (nodular, and subacute to chronic)		Biopsy of the skin confirms the diagnosis
Pulmonary Tuberculosis		No cutaneous involvement	Acid fast bacteria	Sputum positive for
Nocardiosis		Immunocompromised people worldwide distribution		Microscopic examination ; thin, branching gram-positive bacilli acid fast positive