Caused by blastomyces dermatiditis
Geographic distribution:
South/south-central states, upper Midwest and Mississippi and Ohio river valley
Clinical features:
Primary infection affects the lung ( inhalation)
Extra pulmonary disease ( hematogenous spread)
Skin( common): well-circumscribed verrucous nodules and plaques with violaceous hue that may progress to micro abcesses, ulcers.
Bones( osteomyelitis), brain and prostrate
Disseminated disease can affect even immunocompetent individual, but more severe in immunodeficiency
Diagnosis:
KOH prep: broad based budding yeast
Treatment:
Itraconazole(Mild cases)
Severe pulmonary disease/ Imunocompromised patients IV amphotericin B
