Blastomycosis is a fungal disease found in humans, dogs, and other mammals, occasionally cats. It is caused by the fungal organism Blastomyces dermatitidis. Blastomycosis is a rare disease infecting only about 4 in every 100,000 people. Blastomycosis is distributed internationally; cases are sometimes reported from Africa. It is at least six times more common in men than in women and tends to more often infect children and individuals in the 30-50 year old age group. The infection is seen in 1-2 out of every 100,000 people in areas where the fungus most frequently occurs. The disease usually affects people with weakened immune systems, such as those with HIV or organ transplant recipients.
Men are more likely to be affected than women. Lung infection may produce no symptoms, but when the infection spreads, skin lesions or bone lesions may appear and the bladder, kidney, prostate, and testes may be affected. Symptoms of blastomycosis include cough (may produce brown or bloody mucus) ,shortness of breath ,sweating ,fever ,fatigue ,general discomfort, uneasiness, or ill-feeling (malaise) ,unintentional weight loss ,joint stiffness and joint pain ,muscle stiffness and pain ,rash ,skin lesions and chest pain. Blastomycosis of the skin appears as enlarging raised lesions with ulcerating centers. These usually occur on the exposed parts of the body, including the face, hands, wrists, feet, and ankles.
Blastomycosis develops when spores of the B. dermatitidis are breathed in and establish a primary infection in the lung. Treatment with the fungicidal drug ketoconazole (Nizoral) taken orally is effective in about 75% of patients. Amphotericin B (Fungizone) given intravenously is also very effective, but it has more toxic side effects than ketoconazole. Itraconazole is the newest drug used to treat blastomycosis. It is given orally twice a day at first, then once daily for 60-90 days. Amphotericin B is considerably more toxic, and is usually reserved for critically ill patients and those with central nervous system disease. Some antifungal herbs, like garlic (Allium sativum), can be consumed in relatively large doses and for an extended period of time in order to increase effectiveness.
Blastomycosis - Prevention and Treatment Tips
1. Itraconazole given orally is the treatment of choice for most forms of the disease.
2. Amphotericin B is considerably more toxic. Amphotericin B is the drug of choice for treating children.
3. Avoiding travel to areas where the infection is known to occur may help prevent exposure to the fungus.
4. Supplements of vitamins C, E, A-plus, and B complex may also be useful.
5. Ketoconazole given orally twice a day has been effective against blastomycosis.
6. Amphotericin must be given as an intravenous injection.
7. Oral azoles are not beneficial in treating central nervous system blastomycosis.
8. Azoles are not appropriate drugs for CNS disease with the exception of fluconazole.
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