A Case of Blastomyces dermatitidis Diagnosed Following Travel to Colorado: A Case Report and Review of Literature

The dimorphic fungus Blastomyces dermatitidis, is one of the most frequent causes of endemic fungal infections in the United States as well as various other parts of the world. Clinical presentations vary widely, ranging from asymptomatic to disseminated systemic infections. Blastomycosis usually has a predilection for the lungs, but extra pulmonary manifestations are present in 25-40% of cases, involving the skin, bone, genitourinary tract, and CNS. A fungal culture of tissue specimens and fluids is confirmatory. The mainstay of treatment are the azole antifungals, i.e., itraconazole, and for disseminated disease, amphotericin B. We present a case of a young male with pulmonary blastomycosis who presented with a long incubation period. The non-resolving nature of his symptoms prompted further lab and imaging studies, ultimately leading to full and successful recovery.