BLASTOMYCOSIS

infection of the skin and viscera caused by fungal organisms of the genus Blastomyces. There are two major types of blastomycosis: the North American, caused by B. dermatitidis, and the South American, caused by B. brasiliensis. In North American blastomycosis, skin and lung lesions are most common: pulmonary lesions vary in size from granulomatous nodules to confluent, diffuse areas of pus-forming inflammation involving the entire lobe of the lung. In the skin, micro-abscesses lie just beneath the epidermis, the outermost layer of the skin, and are associated with a granulomatous appearance of the surrounding skin. In South American blastomycosis, the portal of entry is usually the nasopharynx (the part of the alimentary canal between the cavity of the mouth and the esophagus that is continuous with the nasal passages); swelling and ulceration of the mouth or nose may cause the infection to spread to the nearby lymph nodes; primary lesions may also occur in the lymphoid tissues in the lower abdomen. In both North and South American varieties, the infection may spread not only to the lymph nodes but also to such organs as the brain, bones, liver, spleen, and adrenals. Treatment includes the use of antibiotics, antifungal agents, and sulfonamide drugs. See also chromoblastomycosis; cryptococcosis.