Blastomycosis differential diagnosis

Jump to navigation Jump to search

Blastomycosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Blastomycosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Blastomycosis differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Blastomycosis differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Blastomycosis differential diagnosis

CDC on Blastomycosis differential diagnosis

Blastomycosis differential diagnosis in the news

Blogs on Blastomycosis differential diagnosis

Directions to Hospitals Treating Blastomycosis

Risk calculators and risk factors for Blastomycosis differential diagnosis

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

Blastomycosis have overlapping signs & symptoms with that of other fungal and bacterial disorders. A detailed History, Physical examination and serological tests helps us to pin-point the diagnosis. All this disorders can be often misinterpreted as community acquired pneumonia as they all present with similar complaints such as fever, productive cough, chest pain and shortness of breath. The following table elaborates differentiating features between blastomycosis from other fungal disorders.

Fungal

Disease Geographic distribution High risk Groups Differentiating Features Microscopic findings Differentiating Laboratory findings
Fungal Histoplasmosis Mississippi and Ohio River valleys
  • Cave dwellers
  • Soil that contains bird or bat dropping
  • Palate and oral ulcers
  • Spleenomegaly
Yeast are typically smaller, with narrow-based budding, found intracellularly within macrophages Pancytopenia

Urine antigen testing

Coccidioidomycosis Southwestern US region Opportunistic infection seen in AIDS
  • Rash on upper body or legs
  • Night sweats
Characteristic spherule appearance Serologic tests( enzyme immune assay )more sensitive
Paracoccidioidomycosis Central and South america Opportunistic infection seen in AIDS
  • Lymphadenopathy
  • Hepatosplenomegaly
  • Bone marrow dysfunction
Smaller fungi with thin cell walls, forming mariner wheel appearance, circumferentially surrounding the parent cell.( Captain wheel appearance ) Elevated liver enzymes

Hyperbilirubinemia

Hypoalbuminemia

Sporotrichosis Ubiquitous Gardeners
  • Person’s hand or the arm
  • Lymphadenitis (nodular)
Finger or cigar shaped yeast. Sporotrichin skin test
Aspergillosis Ubiquitous
  • Cystic fibrosis or asthma. tuberculosis.
  • Immunocomprimised
  • Wheezing
  • Stuffiness, runny nose
  • Hemoptysis
  • Weight loss
Septated hyphae with acute angle branching Cell wall detection using galactomannan antigen detection, Beta-D-glucan detection test.
Bacterial Anthrax Ubiquitous Live stock handlers
  • Painless skin ulcer with a black center 
  • Bloody diarrhea
NonmotileGram-positiveaerobic or facultatively anaerobicendospore-forming, rod-shaped bacterium thrombocytopenia,

hyponatremia,

BUN,

hypoalbuminemia, troponin.

Legionella Ubiquitous Chronic lung disease

Building water systems

  • Diarrhea
  • Confusion
Gram negative bacterium Urine Antigen +

Hyponatreimia

Tuberculosis Asia,Africa Ill contact individuals
  • Night sweats
  • Hemoptysis
Acid fast bacteria
Listeriosis Ubiquitous Pregnant women

Adults > 65

Immunocomprimised.

  • pregnancy can lead to miscarriage, stillbirth, premature delivery,
  • Non-pregnant : headache, stiff neck, confusion, loss of balance, and convulsions
flagellated, catalase-positive, facultative intracellularanaerobicnonsporulatingGram-positive bacillus
Brucellosis
  • Mexico, South and Central America
People who take unpasteurized dairy products
  • Arthritis
  • Testicular and scrotal swelling
  • Endocarditis
Gram-negative bacteria,non-motile, encapsulated coccobacilli.
Scrub typhus Asia-Pacific region

Australia

Afghanistan

Hikers
  • Maculopapular rash
Gram-negative α-proteobacterium  intracellular parasite
Leptospirosis Temperate, tropical climates. People who with animals,
  • Jaundice
  • Red eyes
  • kidney failure
Spiral-shaped bacteria with hooked ends on dark-field.
Cat scratch fever Ubiquitous cat licking a person's open wound, or bites or scratches a person
  • Lymphadenopathy
  • papule or pustule at the infected site
Gram-negative bacteria. facultative intracellular parasites

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

References

Template:WH Template:WS