Vols. Videos

Blastomycosis

Last Updated: October 1, 2018

Figure 1: These images demonstrate a fairly classic appearance of parenchymal blastomycosis. There is a large, cystic lesion with smooth rim enhancement demonstrated before and after contrast (top row), normal diffusivity in the cavity on DWI/ADC (middle row) and a mild amount of surrounding vasogenic edema on T2/FLAIR (bottom row). More commonly, these patients will present with meningitis (not presented here).

Description

  • Caused by the dimorphic fungus Blastomyces dermatitidis
  • Endemic to Ohio and the Mississippi river valley
  • Lung infection with hematogenous spread to the CNS in 5-10% of cases of disseminated infections

Pathology

  • Exists as a mold in the environment and a yeast at body temperatures

Clinical Features

  • Symptoms
    • Nonspecific
    • Headache, AMS, fever, vision...