CLINICAL MANIFESTATIONS OF PULMONARY BLASTOMYCOSIS

Abstract

A review of 35 patients with blastomycosis revealed that 3 exhibited cutaneous lesions only, 4 had pulmonary involvement solely, and 28 had disseminated lesions. Analysis of the clinical manifestations in the 27 patients with pulmonary blastomycosis gave no diagnostic pattern. Prominent symptoms included cough, sputum, fever, chills, hemoptysis, dyspnea, and pleuritis. Physical findings were sparse. The most frequent X-ray change was an infiltrative or fibrotic reaction; pleural reactions and thoracic adenopathy occurred often, but less frequent were cavities, miliary lesions, or pneumonia. This survey points out that the combination of parenchymal pulmonary disease and cutaneous, pleural, bone or thoracic nodal involvement should strongly suggest the diagnosis of blastomycosis.