Blastomycosis (Gilchrist's disease) is a disease caused by the pathogenic fungus Blastomyces dermatitidis. This unit is endemic in the USA, so why mention it in a European country with Poland? Well, rarely, but nevertheless, blastomycosis is found in regions of the world other than America, and in addition, this disease can be confused with completely different entities, such as, for example, lung cancer.

Blastomycosis( Gilchrist's disease ) is a ringworm caused by a fungus of the speciesBlastomyces dermatitidis. Blastomycosis was first described in 1984 by Thomas Casper Gilchrist (hence the other name of this unit, i.e. Gilchrist's disease). Most cases of blastomycosis are recorded in the United States, which is why it is sometimes referred to as North American blastomycosis. Elsewhere in the world, Gilchrist's disease is sporadic, and the overall prevalence of this disease is not significant: according to US statistics, 1 to 40 per 100,000 people develop blastomycosis annually (depending on the region of the country).

Blastomycosis (Gilchrist's disease): causes

The pathogenic fungusBlastomyces dermatitidisleads to blastomycosis. The infection occurs when the microorganism is inhaled into the respiratory system. Most often (even in 70% of patients), the fungus initially grows within the lungs. However, Gilchrist's disease does not develop immediately after infection - the incubation periodBlastomyces dermatitidiscan be either 30 or even 100 days.

Blastomycosis (Gilchrist's disease): symptoms

The symptoms of blastomycosis depend on which part of the body the pathogen develops in. Initially, Gilchrist's disease may resemble a cold or pneumonia: patients may develop a fever, cough or severe weakness. Fungal foci in the lung tissue take various dimensions - if they are visualized through diagnostic imaging, they may suggest, for example, the presence of a lung tumor or tuberculous lesions in the patient. The symptoms of pulmonary blastomycosis can be extremely similar to those that occur in the course of cancer - weight loss, low-grade fever or low-grade fever may occur as a result of Gilchrist's disease.night sweats However, blastomycosis is not a disease that only affects the lungs. The disease-causing microorganism can pass from the respiratory system, through the bloodstream, to other organs - most often the lesions appear in the skin. They can be painless ulcers as well as papillary formations. In the course of Gilchrist's disease, many other organs may be affected, such as:

  • bones (osteolytic changes may appear in them)
  • central nervous system (it can lead to, for example, meningitis or a brain abscess)
  • kidneys
  • prostate (there may be inflammation of the prostate)

Fortunately, the rarest form of blastomycosis is the one in which patients develop acute respiratory distress syndrome. This type of Gilchrist's disease is the most dangerous and is associated with the occurrence of dyspnea, fever, rapid breathing, and general hypoxia.

Important

In medicine, many diseases proceed in such a way that they can be simply confused with each other. This is the case, for example, in patients who are suspected of having lung cancer (e.g. after a chest X-ray). Indeed, visualization of round lung lesions may result from a life-threatening lung tumor, but such changes may also be caused by a fungal infection - blastomycosis.

Blastomycosis (Gilchrist's disease): diagnosis

Based on the possible symptoms of blastomycosis described above, it is difficult to conclude that it was this fungal infection that affected the patient. To obtain confirmation that the patient's ailments are related to the infection withBlastomyces dermatitidis , microscopic examinations must be performed. In this way, it is possible to analyze sputum, skin scrapings or blood or bronchopulmonary washings obtained from patients. Sometimes a tissue biopsy of the affected organs is performed, from which the obtained material is sent for histopathological analysis.

Blastomycosis (Gilchrist's disease): treatment

Theoretically, in people with a properly functioning immune system, the disease may even resolve spontaneously, however, due to the risk associated with it, usually patients are treated with it anyway.

Pharmacotherapy is used in the treatment of blastomycosis. Patients are given drugs such as amphotericin B, ketoconazole, itraconazole or fluconazole. It is not the case that a patient with Gilchrist's disease can be given any of the above-mentioned preparations. The selection of a specific drug depends, among others, on on which part of the body the fungal outbreaks are located in.For example, if a patient has spreadBlastomyces dermatitidisinto the central nervous system, he or she will probably be given fluconazole because it is this drug that penetrates well into the CNS tissues.

Blastomycosis (Gilchrist's disease): prognosis

If only a patient with Gilchrist's disease is treated appropriately, then the prognosis of such a patient is good. According to statistics, among the treated people, whose immune system functions properly, blastomycosis leads to death in 0 to a maximum of 2% of them. The worst prognosis is for those patients who developed acute respiratory distress syndrome related to Gilchrist's disease - in such patients the disease can lead to death in up to 70% of them.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Infectious diseases