Blastomycosis

Abstract

22 cases of Blastomycosis observed in Cincinnati and 36 cases from the files of the Armed Forces Institute of Pathology in Washington are reported. All organs may be involved and hitherto undescribed localizations such as in the pituitary and the peripheral nerves are mentioned. The spread of the disease is by lymphatic, hematic and canalicular pathways. The cutaneous forms are metastases generally from primary pulmonary infections; if true inoculation occurs a skin ulcer, lymphangitis and axillary lymphadenitis develop. The avg. skin case has no lymph node involvement comparable to such a "primary complex." A marked tendency to fibrosis indicates that even generalized cases may be cured; so far no specific treatment has been developed. Surgery gives good results in localized lesions. Transmission of the disease can not be demonstrated by skin testing or clinical appraisal of contacts. Focal pulmonary calcification may be due to healed blastomycosis.