Blastomycosis differential diagnosis: Difference between revisions

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Revision as of 14:54, 27 February 2017

Blastomycosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2] Aditya Ganti M.B.B.S. [3]

Overview

Acute pneumonia itself is a mild flu-like illness that needs to be differentiated from a number of other fungal/bacterial disorders. These disorders have overlapping signs & symptoms that often need detailed History, Physical examination and serological tests to pin-point the diagnosis. It can be often misinterpreted as community acquired pneumonia.

Fungal

Bacterial

Viral


Chronic and disseminated disease

Chronic blastomycosis may be initially confused with a malignancy or tuberculosis. While spread to other areas may be confused with malignancy as well. Skin lesions are often misdiagnosed as pyoderma gangreosum or keratoacanthoma. Therefore, a high index of suspicion is needed on the part of physician to diagnose blastomycosis

Disease Differentiating Features Differentiating Laboratory findings
Histoplasmosis Palate and oral ulcers with spleenomegaly Culture findings : yeast are typically smaller, with narrow-based budding, found intracellularly within macrophages

Pancytopenia

Urine antigen testing

Coccidioidomycosis Endemic to southwestern US region Characteristic spherule appearance on culture media .

Serologic tests( enzyme immune assay )more sensitive

Paracoccidioidomycosis Lymphadenopathy,

Hepatosplenomegaly,

Bone marrow dysfunction

Endemic to central and south america

Culture findings smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.
Sporotrichosis Gardeners are at high risk

Lymphadenitis (nodular, and subacute to chronic)

Biopsy of the skin confirms the diagnosis
Pulmonary Tuberculosis No cutaneous involvement Sputum positive for acid fast bacteria
Nocardiosis Immunocompromised people

worldwide distribution

Microscopic examination ; thin, branching gram-positive bacilli

acid fast positive

References

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