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 organs.

Physical Examination

Vital Signs

Fever ^[1]
Tachypnea

Oral cavity

Oral ulcers can be seen in some patients

Lymph nodes

In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.

Neck

No masses

Cardiovascular system

Regular rate and rhythm
Normal S1, S2
No murmurs, rubs, or gallops

Lungs

Findings consistent with parenchymal consolidation such as^[2]

Dullness to percussion
Increased fremitus
Signs of pleura involvement such as pleuritic rub.

Abdominal

Abdomen soft and non-distended with no scars or striations
No pulsatile masses or abdominal bruits ascultated
Spleen not palpable, liver not palpable

Skin

Ulcerative lesions that bleed easily
Verrucous lesions with irregular border and variegated appearance

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 that bleed on touch

Neurological

Normal examination finding unless the infection is disseminated to brain resulting in meningitis,then findings include :

Altered level of consciousness
Nuchal rigidity

Gallery

References

↑ Smith JA, Gauthier G (2015). "New Developments in Blastomycosis". Semin Respir Crit Care Med. 36 (5): 715–28. doi:10.1055/s-0035-1562898. PMID 26398538.
↑ Kauffman, Carol (2011). Essentials of clinical mycology. New York: Springer. ISBN 978-1-4419-6639-1.

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[pmid26398538-1] Smith JA, Gauthier G (2015). "New Developments in Blastomycosis". Semin Respir Crit Care Med. 36 (5): 715–28. doi:10.1055/s-0035-1562898. PMID 26398538.

[2] Kauffman, Carol (2011). Essentials of clinical mycology. New York: Springer. ISBN 978-1-4419-6639-1.

[1]

[2]