Lecture of mycosis Blastomycosis

2021-02-05 12:00 AM

Direct microscopy: the specimen is fluid from tumours, lymph nodes, mucosal fluid or sputum in 20 per cent KOH will detect yeast cells, large size

Another name: Para coccidioidomycosis. Disease caused by Lutz (1908) was first discovered with the name Lutz - Splendora- Almeida, by 1912 Author spender had to understand the cause of the disease. The disease occurs in many South American countries such as Brazil, Chile, Argentina, Uruguay, the disease also occurs in Europe, 90% of cases are men, usually in the age group 40-50, common in workers. shallow.


As the fungus Paracoccidioides Brasiliense’s, there are also two other species: P.teanis and Cerebriform. Almeida classified this species into the genus Paracoccidioides. In 1941 Conant and Howel named melasma as Blastomyces Brasiliense’s. This can be found in soil.

Clinical symptoms

Mucosal diseases: common in mouth, nose, throat. Initial lesions are granulomas on the oral mucosa, the tongue gradually spreads to form a plaque or ulcer, alternating with red spots and pale-yellow spots. The disease can spread to the palate, tongue and throat. When the patient is sick, he often has increased salivation and drooling.

Skin diseases: common diseases in the face, extremities or body. Lesions are usually papules, papules, and ulcers that gradually turn into papilloma’s, keratosis. The subcutaneous tissue is also inflamed and leads to a deep necrotic ulcer, with a thickened border. The patient usually has little or no pain.

Lung disease: often has symptoms such as cough, hoarseness, difficulty breathing, wheezing, no fever. The disease should be examined by X-ray, in 80% of cases, infiltration images, millet image, pleural lesions are detected.

The fungus Brasiliense’s can also cause diseases in the gastrointestinal tract such as the appendix, cysts, rectum, or cause osteomyelitis or CNS inflammation. When the systemic fungal infection of the patient can die after a few months, when the skin, mucous membranes, or cranes can be after a few years if not detected and treated promptly.

Diagnostic tests

Direct microscopy: specimen is fluid from tumours, lymph nodes, mucosal fluid or sputum in 20% KOH will detect yeast cells, large size 10 - 30µm in diameter, with buds size 1 - 2µm . It can be stained or stained for gram into staining mushroom cells, large cells, growing small shoots.

Culture: This is a dimorphism, so we can grow the specimens at two different temperatures. When cultured in savoured medium, blood agar, chocolate medium at room temperature after 20-40 days, fine-fibre colonies develop, white after turning brown, microscopic observations on fibers the fungus has spores with stalks attached to the hyphae, size of the spores 2.5 - 6 µm. Thick-membrane spores also appear, sometimes on the surface of the colony slightly wrinkled and sometimes reddened, after a period of discoloration. When cultured at a temperature of 370 C, mushrooms grow slowly, have the form of yeast colonies, check microscopic mushroom cells with round shape, diameter 10-16µm, around this "mother" cell there are "daughter cells. "bud mounted, typically shaped like a" rudder ", from these daughter cells continue to grow shoots to form a chain of cells. From the mother, the cell may appear 200-300 shoot cells. Between the strand phase and the yeast phase changes easily when the culture temperature changes.

Differential diagnosis

Need differential diagnosis from other systemic fungal diseases, tuberculosis, tuberculosis.


Often used amphotericin B. Nowadays itraconazole can be used, the drug is effective and less toxic.