Thursday, January 3, 2019

What is Blastomycosis ?

This patient has ARDS, and is waiting for a diagnosis.

               Not everything you get that causes a respiratory infection is a virus or a bacteria.  Today, I have chosen to pass along some information about Blastomycosis.

               Blastomycosis, also known as Gilchrist's Disease, is a fungal disease, that is found in dirt and wet decaying organic matter. It is also known as "North American Blastomycosis".  It can infect the skin, and can affect the skin of dogs and cats also, but most often, we hear about Blastomycosis after it is inhaled, and then within a number of days it creates a pneumonia.  I worry about this kind of thing rather a lot because I am allergic to molds, and when I provide hay to alpacas, horses, sheep or others, I worry that there are varietal molds in the hay, and sometimes, there are.

              In North America, it is most often found in :

      Southern Canada, Upstate, New York, The Ohio and Mississippi River Valleys, the US Mid-Atlantic and Southeast, and the Northern Mid-west.  There is also a version which afflicts Africa and the Middle East.

              The subject inhales the buds of this fungus, and then it grows and may spread.  It is an opportunistic infection, which means that most often we expect the patient to have something else going on that allowed them to become infected with this fungus.  It is possible for this infection to spread throughout the body including the spine, the brain,  and the bone marrow.  It can cause a brain abscess and meningitis.  It is diagnosed through chest x-ray and then lab confirmation of the fungus through samples. There are some very specific hospital lab tests for it now also. It can also create some rather impressive and frightening looking skin lesions.

               A systemic infection with blastomycosis can be treated by an inpatient hospitalization, and with a number of treatments with a drug called Amphotericin-B.   This can become a life threatening disease, leading to adult respiratory distress syndrome (ARDS) especially by virtue of the fact that it can become quite advanced before the diagnosis is made, and because this may not be the first thing your physician was considering.

             It is wise to own facial masks which one should use when working with hay, dirt, near rivers, or anywhere where you are likely to inhale spores of any kind.  Change your disposable mask fairly often and wash and dry your cloth masks regularly.  I wear one whenever I am cleaning or sweeping in the barn or any enclosed space.

             It is possible to get a milder version of this illness which can be treated on an outpatient basis with oral anti-fungals.

              I wanted to make my readership aware of this, because although this does not occur frequently, it does occur, and certainly treatment with antibiotics will not improve it, in fact, it may well worsen it.

This is additional information for those who wish to read more: