Blastomycosis - Revision history

ClaireLewis at 22:36, 26 December 2016

2016-12-26T22:36:40Z

← Older revision		Revision as of 22:36, 26 December 2016
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	**Ulcers that bleed easily and well-demarcated		**Ulcers that bleed easily and well-demarcated
	*Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess		*Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess
	*Genitourinary: [[Prostatitis]], [[~~epididymo-orchitis~~]]		*Genitourinary: [[Prostatitis]], [[Epididymorchitis]]
	*CNS: [[Meningitis]], epidural~~/intracranial~~ abscess in immunocompromised		*CNS: [[Meningitis]], [[epidural abscess]] [[Brain abscess]] in immunocompromised
	*Can involve breast, adrenal, thyroid, eye, lymph node, liver, spleen		*Can involve breast, adrenal, thyroid, eye, lymph node, liver, spleen

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	*ID consult		*ID consult
	*Mild or moderate infections: [[Itraconazole]] (200mg TID x 3 days then once or twice daily x 6-12 months)		*Mild or moderate infections: [[Itraconazole]] (200mg TID x 3 days then once or twice daily x 6-12 months)
	**Alternative: [[Fluconazole]] or [[~~ketoconozale~~]] (400-800mg/day)		**Alternative: [[Fluconazole]] or [[ketoconazole]] (400-800mg/day)
	**Azoles embryotoxic and teratogenic, avoid in pregnancy		**Azoles embryotoxic and teratogenic, avoid in pregnancy
	*Severe infection: [[Amphotericin B]] (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)		*Severe infection: [[Amphotericin B]] (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)

Rossdonaldson1: Text replacement - "CXR" to "CXR"

2016-09-09T10:08:08Z

Text replacement - "*CXR" to "*CXR"

← Older revision		Revision as of 10:08, 9 September 2016
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	*Serologic testing		*Serologic testing
	*HIV testing		*HIV testing
	*CXR: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe infiltrate, perihilar lymph nodes		*[[CXR]]: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe infiltrate, perihilar lymph nodes
	*Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy		*Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy
	*Xray of bone: Well-circumscribed osteolytic lesion		*Xray of bone: Well-circumscribed osteolytic lesion

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T12:04:24Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 12:04, 22 July 2016
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	*Keratoacanthoma		*Keratoacanthoma

	==~~Diagnosis~~==		==Evaluation==
	===Workup===		===Workup===
	*Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds		*Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds

Neil.m.young: Text replacement - "* " to "*"

2016-07-05T01:01:34Z

Text replacement - "* " to "*"

← Older revision		Revision as of 01:01, 5 July 2016
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	==Background==		==Background==
	* [[Fungus]]: Blastomyces dermatitidis		*[[Fungus]]: Blastomyces dermatitidis
	* Lives in moist soil, wooded areas		*Lives in moist soil, wooded areas
	** Spores are airborne		**Spores are airborne
	* North, Central and South America		*North, Central and South America
	** Southeast and Midwest US (Mississippi and Ohio River valleys)		**Southeast and Midwest US (Mississippi and Ohio River valleys)
	*Causes a systemic pyogranulomatous infection		*Causes a systemic pyogranulomatous infection
	* '''Reportable disease'''		*'''Reportable disease'''

	==Clinical Features==		==Clinical Features==
	*Up to 50% of cases will be asymptomatic		*Up to 50% of cases will be asymptomatic
	* Incubation period: 3-6 weeks		*Incubation period: 3-6 weeks
	* Flu like symptoms: [[Fever]], chills, cough, muscle aches, joint pain, [[chest pain]]		*Flu like symptoms: [[Fever]], chills, cough, muscle aches, joint pain, [[chest pain]]
	* Other systemic symptoms: Weight loss, night sweats, chills		*Other systemic symptoms: Weight loss, night sweats, chills
	* Pulmonary: most common		*Pulmonary: most common
	** Acute or chronic pneumonia		**Acute or chronic pneumonia
	** Diffuse pneumonitis, [[ARDS]]		**Diffuse pneumonitis, [[ARDS]]
	* Skin:		*Skin:
	** Verrucous lesion with irregular borders		**Verrucous lesion with irregular borders
	** Microabscess (cold), subcutaneous nodules like erythema nodosum		**Microabscess (cold), subcutaneous nodules like erythema nodosum
	** Ulcers that bleed easily and well-demarcated		**Ulcers that bleed easily and well-demarcated
	* Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess		*Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess
	* Genitourinary: [[Prostatitis]], [[epididymo-orchitis]]		*Genitourinary: [[Prostatitis]], [[epididymo-orchitis]]
	* CNS: [[Meningitis]], epidural/intracranial abscess in immunocompromised		*CNS: [[Meningitis]], epidural/intracranial abscess in immunocompromised
	* Can involve breast, adrenal, thyroid, eye, lymph node, liver, spleen		*Can involve breast, adrenal, thyroid, eye, lymph node, liver, spleen

	==Differential Diagnosis==		==Differential Diagnosis==
	* [[Pneumonia]]		*[[Pneumonia]]
	* Malignancy		*Malignancy
	* [[Tuberculosis]]		*[[Tuberculosis]]
	* [[Histoplasmosis]]		*[[Histoplasmosis]]
	* [[Pyoderma gangrenosum]]		*[[Pyoderma gangrenosum]]
	* Keratoacanthoma		*Keratoacanthoma

	==Diagnosis==		==Diagnosis==
	===Workup===		===Workup===
	* Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds		*Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds
	* Antigen test (Serum or urine)		*Antigen test (Serum or urine)
	* Histopathology		*Histopathology
	* Serologic testing		*Serologic testing
	* HIV testing		*HIV testing
	* CXR: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe infiltrate, perihilar lymph nodes		*CXR: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe infiltrate, perihilar lymph nodes
	* Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy		*Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy
	* Xray of bone: Well-circumscribed osteolytic lesion		*Xray of bone: Well-circumscribed osteolytic lesion
	** Xray vertebrae: Lytic lesion in anterior vertebral body and destruction of disc space		**Xray vertebrae: Lytic lesion in anterior vertebral body and destruction of disc space
	* Bronchoscopy		*Bronchoscopy

	==Management==		==Management==
	* ID consult		*ID consult
	* Mild or moderate infections: [[Itraconazole]] (200mg TID x 3 days then once or twice daily x 6-12 months)		*Mild or moderate infections: [[Itraconazole]] (200mg TID x 3 days then once or twice daily x 6-12 months)
	** Alternative: [[Fluconazole]] or [[ketoconozale]] (400-800mg/day)		**Alternative: [[Fluconazole]] or [[ketoconozale]] (400-800mg/day)
	**Azoles embryotoxic and teratogenic, avoid in pregnancy		**Azoles embryotoxic and teratogenic, avoid in pregnancy
	* Severe infection: [[Amphotericin B]] (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)		*Severe infection: [[Amphotericin B]] (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)
	** All immunocompromised patient should receive [[amphotericin B]]		**All immunocompromised patient should receive [[amphotericin B]]
	** Lipid for all patients, except children		**Lipid for all patients, except children
	** If CNS involvement, lipid for all patients		**If CNS involvement, lipid for all patients

	==Disposition==		==Disposition==
	* Subclinical disease: Observation and no treatment		*Subclinical disease: Observation and no treatment
	* Patients with immunosuppression or progressive pulmonary or extrapulmonary symptoms need treatment and often admission		*Patients with immunosuppression or progressive pulmonary or extrapulmonary symptoms need treatment and often admission
	* Some may need ICU		*Some may need ICU

	==See Also==		==See Also==
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	==External Links==		==External Links==
	* http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Blastomycosis.pdf		*http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Blastomycosis.pdf

	==References==		==References==

Alvarez13 at 00:05, 4 June 2016

2016-06-04T00:05:13Z

← Older revision		Revision as of 00:05, 4 June 2016
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	* Skin:		* Skin:
	** Verrucous lesion with irregular borders		** Verrucous lesion with irregular borders
	** Microabscess (cold), subcutaneous nodules		** Microabscess (cold), subcutaneous nodules like erythema nodosum
	** Ulcers that bleed easily and well-demarcated		** Ulcers that bleed easily and well-demarcated
	* Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess		* Bone: Osteomyelitis, chronic draining sinus, paravertebral abscess

Alvarez13 at 00:04, 4 June 2016

2016-06-04T00:04:04Z

← Older revision		Revision as of 00:04, 4 June 2016
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	* Serologic testing		* Serologic testing
	* HIV testing		* HIV testing
	* CXR: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe ~~infiltrat~~		* CXR: Alveolar infiltrates +/- cavitation, mass lesions, miliary or reticulo- or fibronodular pattern, pleural effusions, upper lobe infiltrate, perihilar lymph nodes
	* Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy		* Chest CT: Nodules, consolidation +/- cavitation, tree-in-bud opacities, pleural effusion, lack hilar adenopathy
	* Xray of bone: Well-circumscribed osteolytic lesion		* Xray of bone: Well-circumscribed osteolytic lesion

Mholtz at 06:52, 18 August 2015

2015-08-18T06:52:02Z

← Older revision		Revision as of 06:52, 18 August 2015
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	* [[Fungus]]: Blastomyces dermatitidis		* [[Fungus]]: Blastomyces dermatitidis
	* Lives in moist soil, wooded areas		* Lives in moist soil, wooded areas
	* Spores airborne		** Spores are airborne
	* Incubation: 3-6 weeks
	* North, Central and South America		* North, Central and South America
	* Southeast and Midwest US (Mississippi and Ohio River valleys)		** Southeast and Midwest US (Mississippi and Ohio River valleys)
	* Reportable disease		*Causes a systemic pyogranulomatous infection
	* Systemic pyogranulomatous infection		* '''Reportable disease'''

	==Clinical Features==		==Clinical Features==
			*Up to 50% of cases will be asymptomatic
			* Incubation period: 3-6 weeks
	* Flu like symptoms: [[Fever]], chills, cough, muscle aches, joint pain, [[chest pain]]		* Flu like symptoms: [[Fever]], chills, cough, muscle aches, joint pain, [[chest pain]]
	* ~~Up to 50% asymptomatic~~		* Other systemic symptoms: Weight loss, night sweats, chills
	* Systemic: Weight loss, night sweats, chills
	* Pulmonary: most common		* Pulmonary: most common
	** Acute or chronic pneumonia		** Acute or chronic pneumonia
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	* Keratoacanthoma		* Keratoacanthoma

	==Workup==		==Diagnosis==
			===Workup===
	* Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds		* Fungal culture (Blood, sputum, bone marrow, liver or skin) : Broad based buds
	* Antigen test (Serum or urine)		* Antigen test (Serum or urine)
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	==Disposition==		==Disposition==
	* Subclinical disease: Observation and no treatment		* Subclinical disease: Observation and no treatment
	* Patients with ~~immunocompetence~~ or progressive pulmonary or extrapulmonary symptoms need treatment and often admission		* Patients with immunosuppression or progressive pulmonary or extrapulmonary symptoms need treatment and often admission
	* Some may need ICU		* Some may need ICU

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	* http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Blastomycosis.pdf		* http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Blastomycosis.pdf

	==~~Sources~~==		==References==
	<references/>		<references/>
	* http://www.cdc.gov/fungal/diseases/blastomycosis/information.html
	** Bradsher RW, et al. Clinical manifestations and diagnosis of blastomycosis. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 43, 2014.
	** Chapman SW, et al. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. CID. 2008; 40: 1801-1812.
	** Bradsher RW, et al. Treatment of blastomycosis. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014.
	** Varkey B, et al. (2014, Jun 30).Blastomycosis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/296870-overview

	[[Category:ID]]		[[Category:ID]]

Rossdonaldson1: /* Sources */

2014-12-30T06:26:00Z

Sources

← Older revision		Revision as of 06:26, 30 December 2014
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	** Bradsher RW, et al. Treatment of blastomycosis. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014.		** Bradsher RW, et al. Treatment of blastomycosis. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014.
	** Varkey B, et al. (2014, Jun 30).Blastomycosis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/296870-overview		** Varkey B, et al. (2014, Jun 30).Blastomycosis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/296870-overview

			[[Category:ID]]

Rossdonaldson1: /* Management */

2014-12-28T03:34:46Z

Management

← Older revision		Revision as of 03:34, 28 December 2014
Line 47:		Line 47:
	==Management==		==Management==
	* ID consult		* ID consult
	* Mild or moderate infections: Itraconazole (200mg TID x 3 days then once or twice daily x 6-12 months)		* Mild or moderate infections: [[Itraconazole]] (200mg TID x 3 days then once or twice daily x 6-12 months)
	** Alternative: Fluconazole or ketoconozale (400-800mg/day)		** Alternative: [[Fluconazole]] or [[ketoconozale]] (400-800mg/day)
	**Azoles embryotoxic and teratogenic, avoid in pregnancy		**Azoles embryotoxic and teratogenic, avoid in pregnancy
	* Severe infection: Amphotericin B (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)		* Severe infection: [[Amphotericin B]] (Lipid 3-5mg/kg IV daily or deoxycholate 0.7-1mg/kg IV daily)
	** All immunocompromised patient should receive amphotericin B		** All immunocompromised patient should receive [[amphotericin B]]
	** Lipid for all patients, except children		** Lipid for all patients, except children
	** If CNS involvement, lipid for all patients		** If CNS involvement, lipid for all patients

Rossdonaldson1: /* Differential Diagnosis */

2014-12-28T03:33:34Z

Differential Diagnosis

← Older revision		Revision as of 03:33, 28 December 2014
Line 26:		Line 26:

	==Differential Diagnosis==		==Differential Diagnosis==
	* Pneumonia		* [[Pneumonia]]
	* Malignancy		* Malignancy
	* Tuberculosis		* [[Tuberculosis]]
	* Histoplasmosis		* [[Histoplasmosis]]
	* Pyoderma gangrenosum		* [[Pyoderma gangrenosum]]
	* Keratoacanthoma		* Keratoacanthoma