dermatitidis is a dimorphic fungus that may cause a systemic pyogranulomatous inflammation following inhalation of conidia in both immunocompetent and immunocompromised patients.
and Histoplasma antigen as well as serum cryptococcal antigen assays were negative.
Blastomycosis is an uncommon and underdiagnosed disease caused by inhalation of Blastomyces
There is cross-reactivity of the Histoplasma antigen test with antigens from other endemic mycoses including Blastomyces
dermatitidis, Paracoccidioides brasiliensis, Coccidioides immitis, and Coccidioides posadasii .
Cases of EN due to fungal pathogens such as Blastomyces
, Aspergillus species, and Mucormycosis have been described less frequently.
Urine was submitted for Blastomyces
quantitative sandwich enzyme immunoassay (EIA; Miravista Diagnostics) and was negative.
Basic Local Alignment Search Tool (BLAST) revealed 93% identity with Hsp60 from Blastomyces
dermatitidis and Histoplasma capsulatum, and 89 and 81% with Hsp60 from Aspergillus fumigatus and Sporothrix schenckii, respectively (data not shown).
Smith, "Cutaneous lesions showing giant yeast forms of Blastomyces
dermatitidis," Journal of Cutaneous Pathology, vol.
Klein, "Altered expression of surface alpha-1,3-glucan in genetically related strains of Blastomyces
dermatitidis that differ in virulence," Infection and Immunity, vol.
(2) Although these methods have the advantage of being non-invasive, but enclose several limitations, including (i) marked intra-patients variation in results; (ii) long time for positive results (up to six weeks are required after exposure for antibody production); (iii) potential cross-reactivity with antibodies produced by other fungi such as Blastomyces
to efficiently evade/manipulate the host immune response, occasionally based on studies performed in other endemic dimorphic fungi (Blastomyces
dermatitidis, Histoplasma capsulatum), where there is deeper understanding of the molecular mechanisms associated with key microbial components.
Among infectious causes, the most common pathogens causing cavitary lesions include bacteria (Klebsiella and Staph aureus), mycobacterial (tuberculosis, avium complex), fungi (Aspergillus, Blastomyces
, Coccidioides, and histoplasma), and parasite (Echinococcus).
dermatitidis causes this relatively rare fungal disease.
Examples of such fungi include Blastomyces
, Coccidioides, and Histoplasma.