North American blastomycosis, an infection caused by inhaling the fungus Blastomyces dermatitidis. It may resemble bacterial pneumonia, and x-ray films of the chest may show cavities. Painless, well-demarcated verrucous or ulcerated skin lesions occur on the face and hands. Occasionally lesions of the oral mucous membrane may be mistaken for squamous cell carcinoma. The disease may progress to involve bones and the brain; many viscera are infected in fatal cases. Diagnosis is made by microscopic examination of body secretions. Treatment is ketoconazole/itraconazole or amphotericin B given intravenously, depending on the severity, or in the most severe cases a combination of amphotericin B and sulfonamides. Also called Gilchrist’s disease. Compare paracoccidioidomycosis.
