Blastomycosis clinical presentation

In patients with mild pulmonary blastomycosis, the clinical presentation of the patient, the immune competence of the patient, and the toxicity of the antifungal agents are the main determinants of whether or not to administer antifungal therapy. All immunocompromised patients and patients with progressive disease or with extrapulmonary disease should be treated (Table 38-2). 

Colonization does not occur with Blastomyces. Acute pulmonary blastomycosis generally is an asymptomatic or self-limited disease characterized by fever, shaking chiUs, and productive, purulent cough, with or without hemoptysis, in immunocompetent individuals. The clinical presentation may be difficult to differentiate from other respiratory infections, including bacterial pneumonia, on the basis of clinical symptoms alone. 

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