Blastomyces dermatitidis

Miconazole. Miconazole (Fig. 2, 7a) is also available as a sterile solution for intravenous infusion. Miconazole has a therapeutic effect on systemic mycoses due to C albicans A.spergillusfumigatus Cyptococcus neoformans Blastomyces dermatitidis Histoplasma capsulatum Coccidioides immitis Paracoccidioides brasiliensis and Petriellidum boydii. 

Fungal (histoplasmosis, coccidioidomycosis, cryptococcosis, Blastomyces dermatitidis infection)... 

North American blastomycosis is a systemic fungal infection caused by Blastomyces dermatitidis. 

Amphotericin B is used to treat systemic disseminated fungal infections caused by Candida spp., Cryptococcus neoformans, and the invasive dimorphic fungi Aspergillus spp., Histoplasma capsulatum, Coccidioides immi-tis, Blastomyces dermatitidis, and Sporothrix schenckii). Intravenous amphotericin B remains the treatment of choice for serious invasive fungal infections unresponsive to other agents. 

Blastomyces dermatitidis is highly endemic in river banks of most eastern states of North America, and there are worldwide reports of this infection including Africa, India and Europe, where its rare appearance is most probably related to contact with fomites. Skin lesions are a very common sign of chronic disease and appear as either pustules developing to ulcers or papules growing to verrucous lesions over months. African blastomycosis is characterized by bone infection and draining sinuses, traumatic implantation presenting as a chancroid-like lesion. Treatment amphotericin B is used for severe acute disease, otherwise ketoconazole, fluconazole or itraconazole have been effective. 

For systemic treatment of fungal infections in dogs and cats, ketoconazole and fluconazole are available as tablets and oral suspensions, itraconazole as capsules, while miconazole and fluconazole are available as parenteral solutions. Even though ketoconazole is often effective, itraconazole may be the preferred azole for the treatment of systemic disease caused by dimorphic fungi (Blastomyces dermatitidis, Histoplasma capsulatum, Sporothrix schenckii). The activity of fluconazole against dimorphic fungi is limited to coccidioidal disease (Coccidioides immitis), but this azole penetrates the blood-brain barrier. 

Blastomycosis is caused by Blastomyces dermatitidis and generally is an asymptomatic, self-limited disease however, reactivation can lead to chronic disease. Although treatment for self-limited disease is controversial, patients with chronic pulmonary disease or extrapulmonary disease... 

Histoplasma capsulatum Blastomyces dermatitidis Coccidioides immitis Pulmonary disease Faster, safer than culture Faster, safer than culture B4 B4... 

Sporothrix schenckii may be confused in tissue sections with Blastomyces dermatitidis and fungal agents of phaeohyphomycosis. In addition, yeast cells of Sporothrix schenckii may be sparsely present in tissues. Antibodies against yeast cells of S. schenckii are sensitive but demonstrate cross-reactivity with Candida species however, after specific adsorption of the antibody with Candida yeast cells, the cross-reactivity of the antibodies is eliminated. 

The diamidines also are fungicidal. Activity in vitro against Blastomyces dermatitidis led to the successful therapeutic trial of these drugs in systemic blastomycoses. The use of amphotericin B, however, has reduced the value of the diamidines in the treatment of this disease. At near-therapeutic levels, pentamidine kills nonreplicating forms of P. jiroveci in culture, but other evidence suggests that pentamidine exerts a biostatic rather than biocidal effect. 

ANTIFUNGAL ACTIVITY Azoles are active against C. albicans, C. tropicalis, C. parap-silosis, C. glabrata, C. neoformans, Blastomyces dermatitidis, Histoplasma capsulatum, Coccid-ioides species, Paracoccidioides brasiliensis, and dermatophytes. Aspergillus spp., Scedosporium apiospermum (Pseudallescheria boydii), Fusarium, and Sporothrix schenckii are intermediate in susceptibihty. C. krusei and the agents of mucormycosis are resistant. 

N. American blastomycosis Soil, probably restricted Blastomyces dermatitidis... 

Aerobacter aerogenes Clostridium sp. M. chelonae Blastomyces dermatitidis Cytomegalovirus Trichomonas vaginalis... 

Reed, K.D., Meece, J.K., Archer, J.R., Peterson, A.T. (2008). Ecologic niche modeling of Blastomyces dermatitidis in Wisconsin. PLoS ONE 3,1-7. 

Aspergillus fumigatus Blastomyces dermatitidis Coccidioides immitis... 

Blastomycetic dermatitis Fungal skin disease caused by Blastomyces dermatitidis characterized by disfiguring, granulomatous, pus-producing lesions. 

Aspergillus fumigatus Blastomyces dermatitidis Coccidioides immitis Histoplasma capsulatum Histoplasma farcimimosum Paracoccidioides braziliensis... 

Blastomycosis Blastomyces dermatitidis North and Central America, Middle East, India, Poland, Zimbabwe Wood debris and soil close to rivers Agricultural workers... 

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