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Prognosis and Therapy of Blastomycosis

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Blastomycosis

Part of the book series: Current Topics in Infectious Disease ((CTID))

Abstract

It has become clear that blastomycosis is very similar to histoplasmosis and coccidioidomycosis with respect to the epidemiology and immunology of the infection. As late as 1945, histoplasmosis was considered to be a uniformly fatal infection with less than 75 disseminated cases reported.1 With the advent of histoplasmin skin testing, it became clear that many persons without a clinical history had, indeed, been infected with the fungus.2 Similar findings are being discovered with blastomycosis. Patients with acute infection who recovered despite no therapy with an antifungal agent have been reported. The majority of those cases have been associated with point-source epidemics such as those at Big Fork, Minnesota, and Eagle River, Wisconsin.3,4 In that latter epidemic of blastomycosis, only 9 patients with culture-proven infection were treated with an antifungal agent.5 The other 35 patients with immunologic evidence of infection were not treated; none have had relapse of infection. Edson and Keys reported a number of patients who had no deleterious effects with only observation following surgical resection of a solitary pulmonary nodule as long as no other disease was present.5

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References

  1. Parsons RJ, Zaronfontis CJD: Histoplasmosis in man: Report of 7 cases and review of 71 cases. Arch Intern Med 75:1–23, 1945

    Article  Google Scholar 

  2. Christie A, Peterson JC: Pulmonary calcifications in negative reactors to tuberculin. Am J Public Health 35:1131–1147, 1945

    Article  CAS  Google Scholar 

  3. Tosh FE, Hammerman KJ, Weeks RJ, et al: A common source epidemic of North American blastomycosis. Am Rev Respir Dis 109:525–529, 1974

    PubMed  CAS  Google Scholar 

  4. Klein BS, Vergeront JM, Weeks RJ, et al: Isolation of Blastomyces dermatitidis in soil associated with a large outbreak of blastomycosis in Wisconsin. N Engl J Med 314:529–534, 1986

    Article  PubMed  CAS  Google Scholar 

  5. Edson RS, Keys TF: Treatment of primary pulmonary blastomycosis. Mayo Clin Proc 56:683–685, 1981

    PubMed  CAS  Google Scholar 

  6. Bradsher RW, Ulmer WC, Manner DJ, et al: Intracellular growth and phagocytosis of Blastomyces dermatitidis by monocyte-derived macrophages from previously infected and normal subjects. J Infect Dis 151:57–64, 1985

    Article  PubMed  CAS  Google Scholar 

  7. Bradsher RW, Balk RA, Jacobs RF: Growth inhibition of Blastomyces dermatitidis in alveolar and peripheral macrophages from patients with blastomycosis. Am Rev Respir Dis 135:412–417, 1987

    PubMed  CAS  Google Scholar 

  8. Taft EF, Bradsher RW: Subclinical blastomycosis detected by lymphocyte transformation to Blastomyces antigen. Am Rev Respir Dis 136:A267, 1987

    Google Scholar 

  9. Vaaler AK, Bradsher RW, Davies SF: Evidence of subclinical blastomycosis in forestry workers in northern Minnesota and northern Wisconsin. Am J Med 89:470–475, 1990

    Article  PubMed  CAS  Google Scholar 

  10. McManus EJ, Jones JM: The use of ketoconazole in the treatment of blastomycosis. Am Rev Respir Dis 133:141–143. 1986

    PubMed  CAS  Google Scholar 

  11. Landis FB, Varkey B: Late relapse of pulmonary blastomycosis after adequate treatment with amphotericin B. Am Rev Respir Dis 113:77–81, 1976

    PubMed  CAS  Google Scholar 

  12. Recht LD, Philips JR, Eckman MR, et al: Self-limited blastomycosis: A report of 13 cases. Am Rev Respir Dis 120:1109–1112, 1979

    PubMed  CAS  Google Scholar 

  13. Martin DS, Smith DT: Blastomycosis: I. A review of the literature. Am Rev Tuberc 39:275–304, 1939

    Google Scholar 

  14. Abernathy RS: Clinical features of pulmonary blastomycosis. Ann Intern Med 51:707–727, 1959

    PubMed  CAS  Google Scholar 

  15. Furcolow ML, Watson KA, Tisdall OF, et al: Some factors affecting survival in systemic blastomycosis. Dis Chest 54(suppl):285–296, 1968

    Article  PubMed  Google Scholar 

  16. Witorsch P, Utz JP: North American blastomycosis: A study of 40 patients. Medicine 47:169–200, 1968

    Article  PubMed  CAS  Google Scholar 

  17. Lockwood WR, Allison F Jr, Batson BE, et al: The treatment of North American blastomycosis: Ten years’ experience. Am Rev Respir Dis 100:314–320, 1969

    PubMed  CAS  Google Scholar 

  18. Parker JD, Doto IL, Tosh FE: A decade of experience with blastomycosis and its treatment with amphotericin B. Am Rev Respir Dis 99:895–902, 1969

    PubMed  CAS  Google Scholar 

  19. Seaburg JH, Dascomb HE: Results of the treatment of systemic mycosis. JAMA 188:509–513, 1964

    Article  Google Scholar 

  20. Busey JF: Blastomycosis. III. A comparative study of 2-hydroxystilbamidine and amphotericin B therapy. Am Rev Respir Dis 105:812–818, 1972

    PubMed  CAS  Google Scholar 

  21. Bennett JE: Antifungal agents, in Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases, ed 3. Edinburgh, Churchill Livingstone, 1990, pp 361–370

    Google Scholar 

  22. Abernathy RS: Amphotericin therapy of North American blastomycosis. Antimicrob Agents Chemother 3:208–211, 1967

    Google Scholar 

  23. Sarosi GA, Davies SF: Blastomycosis. State of the art. Am Rev Respir Dis 120:911–938, 1979

    PubMed  CAS  Google Scholar 

  24. Laskey WL, Sarosi GA: Endogenous activation in blastomycosis. Ann Intern Med 88:5052, 1978

    Google Scholar 

  25. Saag MS, Dismukes WE: Azole antifungal agents: Emphasis on new triazoles. Antimicrob Agents Chemother 32:1–8, 1988

    Article  PubMed  CAS  Google Scholar 

  26. Dunbar M Jr, Pyle RL, Boring JG, et al: Treatment of canine blastomycosis with ketoconazole. J Am Vet Med Assoc 182:156–157, 1983

    PubMed  Google Scholar 

  27. Legendre AM, Selcer BA, Edwards DF, et al: Treatment of canine blastomycosis with amphotericin B and ketoconazole. J Am Vet Med Assoc 184:1249–1254, 1984

    PubMed  CAS  Google Scholar 

  28. Harvey RP, Isenberg RA, Stevens DA: Molecular modifications of imidazole compounds: Studies of activity and synergy in vitro and of pharmacology and therapy of blastomycosis in a mouse model. Rev Infect Dis 2:559–569, 1980

    Article  CAS  Google Scholar 

  29. Lewis JH, Zimmerman HJ, Benson GD, et al: Hepatic injury associated with ketoconazole therapy. Gastroenterology 86:503–513, 1984

    PubMed  CAS  Google Scholar 

  30. Pont A, Graybill JR, Craven PC, et al: High-dose ketoconazole therapy and adrenal and testicular function in humans. Arch Intern Med 144:2150–2153, 1984

    Article  PubMed  CAS  Google Scholar 

  31. Bradsher RW, Rice DC, Abernathy RS: Ketoconazole therapy of endemic blastomycosis. Ann Intern Med 103:872–879, 1985

    PubMed  CAS  Google Scholar 

  32. Dismukes WE, Stamm AM, Graybill JR, et al: Treatment of systemic mycoses with ketoconazole: Emphasis on toxicity and clinical response in 52 patients. Ann Intern Med 98:1320, 1983

    Google Scholar 

  33. Symoens J, Moens M, Dom J, et al: An evaluation of two years of clinical experience with ketoconazole. Rev Infect Dis 2:674–687, 1980

    Article  PubMed  CAS  Google Scholar 

  34. Scheid WM: Grand Rounds: North American blastomycosis. Va Med Mon 110:240–248, 1983

    Google Scholar 

  35. Gnann JW Jr, Bressler GS, Bodet CA, et al: Human blastomycosis after a dog bite. Ann Intern Med 98:48–49, 1983

    PubMed  Google Scholar 

  36. Hii JH, Legault L, DeVeber G, et al: Successful treatment of systemic blastomycosis with high-dose ketoconazole in a renal transplant recipient. Am J Kidney Dis 15:595–597, 1990

    PubMed  CAS  Google Scholar 

  37. Tuthill S: Disseminated blastomycosis treated with ketoconazole. South Med J 79:1188–1189, 1986

    Google Scholar 

  38. Moore RM, Green NE: Blastomycosis of bone: A report of six cases. J Bone Jt Surg 64A:1097–1101, 1983

    Google Scholar 

  39. National Institute of Allergy and Infectious Diseases Mycosis Study Group: Treatment of blastomycosis and histoplasmosis with ketoconazole: Results of a prospective, randomized clinical trial. Ann Intern Med 103:861–872, 1985

    Google Scholar 

  40. Hevert CA, King J, George RB: Late dissemination of pulmonary blastomycosis during ketoconazole therapy. Chest 95:240–242, 1989

    Article  Google Scholar 

  41. Pitrak DL, Andersen BR: Cerebral blastomycoma after ketoconazole therapy for respiratory tract blastomycosis. Am J Med 86:713–714, 1989

    Article  PubMed  CAS  Google Scholar 

  42. Van Cauteren HJ, Heykants J, De Coster R, et al: Itraconazole: Pharmacologic studies in animals and humans. Rev Infect Dis 9:S43–46, 1987

    Article  PubMed  Google Scholar 

  43. Dismukes W, Bradsher R, Girard W, et al: Itraconazole therapy for blastomycosis and histoplasmosis [abstract 798]. NIAID Mycosis Study Group. 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, 1986

    Google Scholar 

  44. Bradsher RW: Itraconazole therapy of blastomycosis: Cure following progression or relapse after ketoconazole [abstract 1351]. New York, 27th Interscience Conference on Antimicrobial Agents and Chemotherapy, 1987

    Google Scholar 

  45. Dismukes W, Bennett JE, Drutz DJ, et al: Criteria for evaluation of therapeutic response to antifungal drugs. Rev Infect Dis 2:535–545, 1980

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Robert W. Bradsher
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Editors and Affiliations

  1. School of Medicine and Health Sciences, George Washington University, Washington, DC, USA

    Yousef Al-Doory Ph.D.

  2. Nevada State Health Laboratory, Reno, Nevada, USA

    Arthur F. DiSalvo M.D.

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© 1992 Springer Science+Business Media New York

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Bradsher, R.W. (1992). Prognosis and Therapy of Blastomycosis. In: Al-Doory, Y., DiSalvo, A.F. (eds) Blastomycosis. Current Topics in Infectious Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3306-1_12

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  • DOI: https://doi.org/10.1007/978-1-4615-3306-1_12

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6455-9

  • Online ISBN: 978-1-4615-3306-1

  • eBook Packages: Springer Book Archive

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