Blastomycosis: A Challenging Fungal Infection

Blastomycosis is a fungal infection caused by Blastomyces dermatitidis and Blastomyces gilchristii. The disease can affect various organs in the body, with pulmonary infections being the most common. Pulmonary blastomycosis can range from minor pneumonia to severe acute respiratory distress syndrome. Skin involvement is also common, manifesting as nodules, plaques, ulcers, or abscesses. Other sites of infection include the bones, genitourinary tract, and central nervous system. The fungus is thermally dimorphic, existing as a mold in the environment and transforming into yeast in the host. The infection is challenging to diagnose and treat, requiring prolonged antifungal therapy. While blastomycosis can affect immunocompetent individuals, those with compromised immune systems are at higher risk for severe infections and mortality. The ecological traits of blastomyces, such as thermotolerance and evasion of host immune responses, contribute to its pathogenicity. Understanding the natural ecology and interactions with other microbes in the environment can help in the development of new antifungal treatments.