Burying Hatchets into Endemic Diagnoses: Disseminated Blastomycosis from a Potentially Novel Occupational Exposure

Background: Blastomycosis is an endemic fungal disease predominantly observed in the northern regions of North America. It manifests primarily as pulmonary disease but can also involve dissemination to the skin, bones, and genitourinary tract. Detailed Case Description: We describe a case of a patient in Southern California with disseminated blastomycosis following his occupational exposure to decaying wood. The patient was treated with intravenous amphotericin therapy followed by oral itraconazole therapy with full resolution of his symptoms. Conclusions: The patient’s case presentation serves as a reminder regarding Blastomyces infections diagnosed outside of endemic regions and suggests a potential link between blastomycosis and a novel occupational exposure surrounding axe throwing.