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dual infection with pythium insidiosum and blastomyces dermatitidis in a dog.a 4-year-old male neutered labrador retriever with severe gastrointestinal signs, but no respiratory signs, was diagnosed with multifocal pyogranulomatous gastritis, enteritis, and lymphadenitis with intralesional hyphae and multifocal pyogranulomatous pneumonia with intralesional yeast. based on cytologic evaluation, histologic examination with special stains, and immunohistochemical analysis of tissues collected antemortem or at necropsy, dual infections with pythium insidiosum and blastomyces ...201222747656
blastomycosis presenting as a nonhealing wound.a 41-year-old man was referred to the wound clinic for an enlarging 9.5 x 14-cm ulceration of the right upper arm of 8 months' duration. a biopsy was obtained, and fungal stains showed broad-based budding spores typical of blastomycosis. he was treated with oral itraconazole, and the ulcer healed in 2 months. blastomycosis is a systemic fungal infection acquired by inhalation of the spores of the fungus blastomyces dermatitidis. initially a pulmonary infection, the skin is the most common second ...201222713783
what is your diagnosis? infection with dimorphic blastomyces dermatitidis. 201222471821
real-time pcr assay for identification of blastomyces dermatitidis in culture and in tissue.the taqman real-time pcr assay was developed from the blastomyces dermatitidis bad1 gene promoter. the assay identified all haplotypes of b. dermatitidis and five of six positive paraffin-embedded tissues. the assay sensitivity threshold was 1 pg genomic dna of the mold form and 2 cfu of the yeast form of b. dermatitidis. no cross-reactivity was observed against other fungal dna. the assay allowed rapid (5-h) identification of b. dermatitidis from culture and from clinical specimens.201222403418
a large community outbreak of blastomycosis in wisconsin with geographic and ethnic clustering.blastomycosis is a potentially life-threatening infection caused by the soil-based dimorphic fungus blastomyces dermatitidis, which is endemic throughout much of the midwestern united states. we investigated an increase in reported cases of blastomycosis that occurred during 2009-2010 in marathon county, wisconsin.201323735332
variation in clinical phenotype of human infection among genetic groups of blastomyces dermatitidis.blastomyces dermatitidis, the etiologic agent of blastomycosis, has 2 genetic groups and shows varied clinical presentation, ranging from silent infections to fulminant respiratory disease and dissemination. the objective of this study was to determine whether clinical phenotype and outcomes vary based on the infecting organism's genetic group.201323230057
molecular cloning, characterization and differential expression of drk1 in sporothrix schenckii.the dimorphism of sporothrix schenckii (s. schenckii) reflects a developmental switch in morphology and lifestyle that is necessary for virulence. drk1, a hybrid histidine kinase, functions as a global regulator of dimorphism and virulence in blastomyces dermatitidis (b. dermatitidis) and histoplasma capsulatum (h. capsulatum). the partial cdna sequence of drk1 of s. schenckii, designated ssdrk1, was obtained using degenerate primers based on the conserved domain of the drk1 of other fungi. the ...201323175272
identification of the mating-type (mat) locus that controls sexual reproduction of blastomyces dermatitidis.blastomyces dermatitidis is a dimorphic fungal pathogen that primarily causes blastomycosis in the midwestern and northern united states and canada. while the genes controlling sexual development have been known for a long time, the genes controlling sexual reproduction of b. dermatitidis (teleomorph, ajellomyces dermatitidis) are unknown. we identified the mating-type (mat) locus in the b. dermatitidis genome by comparative genomic approaches. the b. dermatitidis mat locus resembles those of ot ...201323143684
blastomyces dermatitidis septins cdc3, cdc10, and cdc12 impact the morphology of yeast and hyphae, but are not required for the phase transition.blastomyces dermatitidis, the etiologic agent of blastomycosis, belongs to a group of thermally dimorphic fungi that change between mold (22°c) and yeast (37°c) in response to temperature. the contribution of structural proteins such as septins to this phase transition in these fungi remains poorly understood. septins are gtpases that serve as a scaffold for proteins involved with cytokinesis, cell polarity, and cell morphology. in this study, we use a gfp sentinel rna interference system to inv ...201322783804
probable blastomyces dermatitidis infection in a young rat.a 21-week-old male untreated control shr/ncrlnarl rat was found dead during an experiment. grossly, pulmonary lesions were characterized by multifocal to coalescing firm gray-white nodules randomly scattered on the surface. microscopically, bronchopneumonia was found with pyogranulomas containing neutrophils, macrophages, and numerous thick-walled yeast cells. yeast cells, 5 to 25 μm in diameter, with no branching of hyphae were observed by staining with hematoxylin and eosin, diff-quik, and per ...201322711744
blastomycosis in india: report of an imported case and current status.we report a case of disseminated blastomycosis in a female resident of delhi, who acquired the infection during travel to the usa, which was successfully treated with oral itraconazole. in addition, we present a critical literature review, indicating that blastomycosis is endemic in india but its areas of endemicity, prevalence, and the natural habitat of the etiologic agent, remain undetermined. the diagnosis of blastomycosis was made by examination of gomori's methenamine silver stained sectio ...201322646243
blastomyces dermatitidis yeast lysate antigen combinations: antibody detection in dogs with blastomycosis.the systemic fungal infection, blastomycosis, which infects both humans and animals has presented a diagnostic challenge for clinicians for many years. the aim of this study was to evaluate the diagnostic sensitivity of blastomyces dermatitidis yeast lysate antigens with respect to antibody detection in dogs with blastomycosis. lysate antigens were prepared from b. dermatitidis isolates t-58 and t-66 (dogs, tennessee) and wi-r and wi-j (dogs, wisconsin). based on results obtained from a prelimin ...201324236239
development of a slide agglutination assay for detection of blastomycosis.blastomycosis, caused by the thermally dimorphic fungus blastomyces dermatitides, which is endemic to eastern regions of the usa, is commonly misdiagnosed as a viral or bacterial infection and therefore treated improperly. over the years, many immunodiagnostic assays to aid in the diagnosis of blastomycosis have been developed; however, a reliable assay for use in local clinics still remains elusive. procedures for a slide agglutination assay for detection of antibody in serum from rabbits immun ...201324028710
detection and identification of yeasts from formalin-fixed, paraffin-embedded tissue by use of pcr-electrospray ionization mass spectrometry.diagnosis of yeast infection is typically accomplished by fungal smear and culture, histopathologic examination, and/or serologic studies. newer assays based on mass spectrometry may be useful for yeast identification when histologic examination is inconclusive, fungal cultures are not ordered, or cultures fail to yield a causative agent. the purpose of this study was to evaluate the ability of the plex-id broad fungal assay to accurately detect and identify yeasts in formalin-fixed paraffin-emb ...201323985922
carpal intra-articular blastomycosis in a labrador retriever.a 6-month-old male castrated labrador retriever was presented for coughing and forelimb lameness. blastomyces dermatitidis was identified in cytology of sputum and synovial fluid. repeat arthrocentesis 7 months later revealed resolution of septic arthritis. fungal septic arthritis should be considered for cases of monoarthritis and may respond to oral itraconazole treatment.201323904641
concomitant fungal and mycobacterium bovis infections in beef cattle in kenya.bovine tuberculosis is an important zoonosis and accurate diagnosis is important for its surveillance. post-mortem diagnosis may, however, be compromised by lesions caused by other pathogens. in an investigation on its prevalence in slaughter cattle in kenya, mycobacterium bovis and dimorphic fungi were inadvertently identified separately or concurrently in tuberculous lesions. beef carcasses were inspected for lesions in two abattoirs in nairobi. tissues with lesions were collected and transpor ...201323902371
granulomatous rhinitis due to candida parapsilosis in a cat.a 9-year-old female spayed domestic medium hair cat presented to the referring veterinarian with a 2-week history of sneezing, which progressed to swelling over the nasal planum. the cat had been under veterinary care for inflammatory bowel disease and had been treated with 1.25 mg/kg prednisolone once a day for approximately 1 year. on physical examination, an approximately 2-3 mm diameter, round polypoid pink soft-tissue mass was protruding slightly from the right nostril. through histologic e ...201323883665
interleukin 1 enhances vaccine-induced antifungal t-helper 17 cells and resistance against blastomyces dermatitidis infection.vaccine-induced t-helper 17 (th17) cells are necessary and sufficient to protect against fungal infection. although live fungal vaccines are efficient in driving protective th17 responses and immunity, attenuated fungi may not be safe for human use. heat-inactivated formulations and subunit vaccines are safer but less potent and require adjuvant to increase their efficacy. here, we show that interleukin 1 (il-1) enhances the capacity of weak vaccines to induce protection against lethal blastomyc ...201323788728
endemic human blastomycosis in quebec, canada, 1988-2011.blastomycosis is a systemic fungal infection found in various parts of the world. a review of literature for quebec, canada revealed only few case reports with the most recent one dating back to 1993. however, whether quebec represents an important endemic region for blastomycosis in north america is unknown. in this work we reviewed 158 cases of human blastomycosis documented in quebec during 1988-2011 using microbiological records available from the provincial public health laboratory. the est ...201322929032
large cerebellar mass lesion: a rare intracranial manifestation of blastomycosis.blastomyces dermatitidis is a dimorphic fungus found endemically in the mississippi and ohio river basins and in the midwestern and canadian provinces that border the great lakes. unlike other fungal infections, it most commonly affects immunocompetent hosts. blastomycosis typically manifests as pulmonary infection, but may affect nearly any organ, including the skin, bone, and genitourinary system. central nervous system (cns) blastomycosis is rare, but potentially fatal manifestation of this d ...201324231945
prevalence and geographic distribution of canine and feline blastomycosis in the canadian prairies.this retrospective study reports patient signalment, method of diagnosis and geographic distribution, and examines trends in prevalence and seasonal distribution of blastomycosis cases submitted to a veterinary diagnostic laboratory in saskatchewan over a 21-year period. of the 143 cases that originated from saskatchewan and manitoba 137 were from canine and 6 from feline patients. signalment was similar to that previously reported. all cases originated in southern saskatchewan and manitoba, pri ...201324155475
successful treatment of pulmonary blastomycosis with continuously infused amphotericin b deoxycholate after failure with liposomal amphotericin b.to describe a case of successful treatment of severe pulmonary blastomycosis with amphotericin b deoxycholate after failure of liposomal amphotericin b.201323673538
clinical and molecular epidemiology of veterinary blastomycosis in wisconsin.several studies have shown that blastomyces dermatitidis, the etiologic agent of blastomycosis, is a genetically diverse pathogen. blastomycosis is a significant health issue in humans and other mammals. veterinary and human isolates matched with epidemiological case data from the same geographic area and time period were used to determine: (i) if differences in genetic diversity and structure exist between clinical veterinary and human isolates of b. dermatitidis and (ii) if comparable epidemio ...201323607640
outcomes of persons with blastomycosis involving the central nervous system.blastomyces dermatitidis is a dimorphic fungus which is potentially life-threatening if central nervous system (cns) dissemination occurs. sixteen patients with proven or probable cns blastomycosis are presented. median duration of symptoms was 90 days; headache and focal neurologic deficit were the most common presenting symptoms. magnetic resonance imaging (mri) consistently demonstrated an abnormality, compared to 58% of computed tomography scans. tissue culture yielded the pathogen in 71% of ...201323566338
intracranial blastomycosis presenting as an enhancing cerebellopontine mass.isolated blastomyces dermatitidis infection of the central nervous system is an uncommonly encountered entity. if left untreated it can be fatal; thus accurate diagnosis in a timely manner is critical. a 37-year-old white male presented with a severe headache. an mri scan revealed a right-sided enhancing cerebellopontine angle mass with extension into the internal acoustic canal and diffuse basilar enhancement. after thorough assessment of the patient, an open surgical biopsy of the lesion was p ...201323546914
phylogenetic analysis reveals a cryptic species blastomyces gilchristii, sp. nov. within the human pathogenic fungus blastomyces dermatitidis.analysis of the population genetic structure of microbial species is of fundamental importance to many scientific disciplines because it can identify cryptic species, reveal reproductive mode, and elucidate processes that contribute to pathogen evolution. here, we examined the population genetic structure and geographic differentiation of the sexual, dimorphic fungus blastomyces dermatitidis, the causative agent of blastomycosis.201323533607
isolation of blastomyces dermatitidis yeast from lung tissue during murine infection for in vivo transcriptional profiling.blastomyces dermatitidis belongs to a group of thermally dimorphic fungi that grow as sporulating mold in the soil and convert to pathogenic yeast in the lung following inhalation of spores. knowledge about the molecular events important for fungal adaptation and survival in the host remains limited. the development of high-throughput analytic tools such as rna sequencing (rna-seq) has potential to provide novel insight on fungal pathogenesis especially if applied in vivo during infection. howev ...201323499858
pulmonary blastomycosis: a new endemic area in new york state.we describe three cases of pulmonary blastomycosis in patients from central new york state (nys). two of these cases occurred in 2012, and in patients who resided in the same county. moreover, two of these cases manifested with acute respiratory distress syndrome and survived. interestingly, one of the two received corticosteroids and was extubated within 1 week. to the best of our knowledge, these are the first cases of human blastomycosis to be reported from nys and we propose that corticoster ...201323496278
n-acetylglucosamine (glcnac) triggers a rapid, temperature-responsive morphogenetic program in thermally dimorphic fungi.the monosaccharide n-acetylglucosamine (glcnac) is a major component of microbial cell walls and is ubiquitous in the environment. glcnac stimulates developmental pathways in the fungal pathogen candida albicans, which is a commensal organism that colonizes the mammalian gut and causes disease in the setting of host immunodeficiency. here we investigate glcnac signaling in thermally dimorphic human fungal pathogens, a group of fungi that are highly evolutionarily diverged from c. albicans and ca ...201324068964
peritoneal blastomycosis: a hidden mystery unfolds itself.blastomycosis is a disease caused by the fungus blastomyces dermatitidis. pulmonary blastomycosis is the most common form of blastomycosis. disseminated blastomycosis is the fulminant form of the disease, with rare reports of peritoneal cavity involvement. we report a case of extensive form of the disease presenting initially as abdominal pain and mimicking peritoneal carcinomatosis.201425675594
effective method for the heat inactivation of blastomyces dermatitidis.manipulation of blastomyces dermatitidis requires the use of containment level 3 (cl3) practices. however, access to cl3 laboratories is limited and working conditions are restrictive. we describe the validation of a "heat-killing" method to inactivate b. dermatitidis, thus allowing cellular material to be removed from the cl3 laboratory for subsequent dna isolation that is suitable for genetic applications.201425049039
blastomycosis of the head and neck.blastomyces dermatitidis infection of head and neck structures is a rare clinical entity. however, the potential for significant morbidity warrants clinical consideration and timely diagnosis.201424486126
c-type lectin receptors differentially induce th17 cells and vaccine immunity to the endemic mycosis of north america.vaccine immunity to the endemic mycoses of north america requires th17 cells, but the pattern recognition receptors and signaling pathways that drive these protective responses have not been defined. we show that c-type lectin receptors exert divergent contributions to the development of antifungal th17 cells and vaccine resistance against blastomyces dermatitidis, histoplasma capsulatum, and coccidioides posadasii. acquired immunity to b. dermatitidis requires dectin-2, whereas vaccination agai ...201424391211
development of a highly sensitive and specific blastomycosis antibody enzyme immunoassay using blastomyces dermatitidis surface protein bad-1.serologic tests for antibodies to blastomyces dermatitidis are not thought to be useful for the diagnosis of blastomycosis, in part due to the low sensitivity of immunodiffusion and complement fixation. earlier studies have shown that the enzyme immunoassay improves the sensitivity of antibody detection for the diagnosis of blastomycosis. microplates coated with the b. dermatitidis surface protein bad-1 were used for testing sera from patients with proven blastomycosis or histoplasmosis and cont ...201424285817
dimorphic fungal osteoarticular infections.the objective of this investigation was to review the clinical manifestations, management, and outcome of osteoarticular infections caused by dimorphic fungi. we exhaustively reviewed reports of bone and joint infections caused by dimorphic fungi published between 1970 and 2012. underlying conditions, microbiological features, histological characteristics, clinical manifestations, antifungal therapy, and outcome were analyzed in 222 evaluable cases. among 222 proven cases (median age 41 years [i ...201424939620
unexpected blastomyces dermatitidis etiology of fungal sinusitis and erosive palatal infection in a diabetic patient.we present what is believed to be the initial report of hard-palate infection caused by blastomyces dermatitidis. the organism was cultivated from biopsy material obtained from a diabetic patient presenting with complaints of headache and malaise. radiologic findings revealed a malignant-appearing soft-tissue mass with paranasal sinus base destruction.201424899035
peritonitis caused by blastomyces dermatitidis in a kidney transplant recipient: case report and literature review.blastomyces dermatitidis is a dimorphic fungus endemic to the midwestern, south-central, and southeastern united states known to cause disseminated infection in immunocompromised individuals. we report a case of b. dermatitidis peritonitis in a renal allograft recipient with new-onset ascites and cytomegalovirus encephalitis. peritoneal blastomycosis is a rare clinical entity and, to our knowledge, this patient represents the first known case of peritoneal blastomycosis in a solid organ transpla ...201424862205
blastomyces dermatitidis: antibody detection in sera from dogs with blastomycosis with yeast lysate antigens produced from human and dog isolates.dogs are common hosts to the fungal organism blastomyces dermatitidis, which causes the systemic disease blastomycosis. the goal of our study was to compare the reactivity of two b. dermatitidis yeast lysate antigens prepared from dog isolates (erc-2, wisconsin; t-58, tennessee) and two lysate antigens prepared from human isolates (b5931 and b5896, minnesota) against 48 serum specimens from dogs with confirmed blastomycosis using the indirect enzyme-linked immunosorbent assay (elisa). secondaril ...201424724039
blastomycosis diagnosed in a nonhyperendemic area.blastomycosis, caused by the dimorphic fungus blastomyces dermatitidis, is hyperendemic in northern wisconsin and is unevenly distributed in the rest of the state and contiguous minnesota. clinical presentation of this illness has been characterized by localized outbreaks and sporadic cases in endemic areas.201424712215
successful treatment of osseous blastomycosis without pulmonary or disseminated disease and review of the literature.blastomycosis commonly occurs following inhalation of blastomyces dermatitidis conidia causing a pulmonary infection and can disseminate to extrapulmonary sites. osseous involvement primarily results from hematogenous spread, but in rare cases, direct inoculation can occur. we describe a case of osseous blastomycosis without pulmonary or disseminated disease successfully treated with posaconazole.201424703876
disseminated blastomyces dermatitidis, genetic group 2, infection in an alpaca (vicugna pacos).a 7-year-old, female huacaya alpaca presented with a 3-week history of left-sided head tilt and mild ataxia. despite aggressive supportive therapy with empirical antibiotic, anti-inflammatory, thiamine, and anthelminthic therapy, neurologic signs progressed to a right-sided head tilt, positional nystagmus, and episodes of severe ataxia and obtundation. on necropsy, discrete expansile to poorly delineated infiltrative masses with tan, creamy to grumous exudate were observed in the right petrous t ...201424621845
isolation of aureimonas altamirensis, a brucella canis-like bacterium, from an edematous canine testicle.microbiological and histological analysis of a sample from a swollen testicle of a 2-year-old border collie dog revealed a mixed infection of the fungus blastomyces dermatitidis and the gram-negative bacterium aureimonas altamirensis. when subjected to an automated microbial identification system, the latter isolate was provisionally identified as psychrobacter phenylpyruvicus, but the organism shared several biochemical features with brucella canis and exhibited agglutination, albeit weakly, wi ...201425292192
vitamin d binding protein polymorphism protects against development of blastomycosis.blastomycosis is an uncommon endemic fungal infection. it is presumed that in the endemic regions, the number of exposed individuals is significantly greater than those in whom clinical manifestations develop. we conducted a case-control study of individuals with clinical blastomycosis and controls with similar exposure but who did not develop disease. a genetic association was observed between the gc-2 allele of vitamin d binding protein and reduced susceptibility to blastomycosis in a canadian ...201425459678
blastomycosis in a postpartum dog.transplacental infection with blastomyces dermatitidis is rare in humans and unknown in the dog. a doberman pinscher bitch was diagnosed with blastomycosis 25 days after whelping. clinical signs were noted after whelping and were progressive. all 9 pups were free of clinical signs and had negative urine blastomyces antigen tests at 6 weeks of age and remained free of signs of illness through 11 months of age. the bitch responded to treatment with itraconazole.201425379395
blastomycosis of bone: a clinicopathologic study.blastomycosis osteomyelitis is a well-known but infrequently encountered complication of infection with the dimorphic mold, blastomyces dermatitidis. oftentimes, the diagnosis is unsuspected, resulting in a delay in making the diagnosis. the role of intraoperative consultation in making a rapid diagnosis has not been discussed previously.201425319975
blastomyces dermatitidis in a renal transplant recipient.fungal pathogens can be the source of serious and sometimes fatal infections following organ transplantation. to the best of our knowledge, we present the first case of cutaneous blastomycosis in a renal allograft recipient in india, a country outside the known endemic regions. this case, with the very rare and unexpected diagnosis of blastomycosis, not only reflects the tremendous diversity of infections in transplant recipients but also emphasizes the utility of serological methods even in the ...201425193904
the endemic mimic: blastomycosis an illness often misdiagnosed.one of the endemic fungi, blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lu ...201425125734
spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.blastomycosis is a disease caused by endemic fungi that ranges from severe pulmonary or disseminated to mild or asymptomatic. environmental factors associated with it are not well described throughout the endemic area. we used the intramural state inpatient database from the agency for healthcare research and quality and arcmap gis to identify geographic high-risk clusters of blastomycosis hospitalizations in 13 states in the us endemic regions (ar, ia, il, in, ky, la, mi, mn, mo, ms, oh, tn, an ...201525908653
extracorporeal membrane oxygenation for blastomycosis-related acute respiratory distress syndrome: a case series.blastomyces dermatitidis is a dimorphic fungus endemic to north america capable of causing fatal respiratory failure. acute respiratory distress syndrome (ards) complicates up to 10% of pulmonary blastomycosis in hospitalized patients and carries a mortality of 50-90%. this report describes the clinical course of four consecutive patients with blastomycosis-related ards treated with venovenous extracorporeal membrane oxygenation (ecmo) during 2009-2014.201525851019
the unappreciated intracellular lifestyle of blastomyces dermatitidis.blastomyces dermatitidis, a dimorphic fungus and the causative agent of blastomycosis, is widely considered an extracellular pathogen, with little evidence for a facultative intracellular lifestyle. we infected mice with spores, that is, the infectious particle, via the pulmonary route and studied intracellular residence, transition to pathogenic yeast, and replication inside lung cells. nearly 80% of spores were inside cells at 24 h postinfection with 10(4) spores. most spores were located insi ...201525589071
isavuconazole, a broad-spectrum triazole for the treatment of systemic fungal diseases.the prodrug isavuconazonium sulfate (bal8557) is an extended-spectrum water-soluble triazole, developed for the treatment of severe invasive and life-threatening fungal diseases. its active moiety, bal4815, is a potent inhibitor of ergosterol biosynthesis, resulting in the disruption of fungal membrane structure and function. the active compound shows broad-spectrum of activity and potency against all major opportunistic fungi, such as aspergillus spp., candida spp., cryptococcus spp., mucorales ...201525488140
ribosomal rna gene sequencing for early diagnosis of blastomyces dermatitidis infection.prompt detection and identification of fungal pathogens at the genus and species level is critical in order to provide timely antifungal therapy. here, we highlight the vital role of molecular diagnostics in achieving a fast and definitive diagnosis of disseminated blastomycosis in a diabetic patient presenting as a brain mass initially thought to be tumoral in nature. a broad-range pcr amplification and sequencing of the fungal ribosomal rna genes on brain biopsy tissue obtained during elective ...201526129971
new developments in blastomycosis.blastomyces dermatitidis, the etiologic agent of blastomycosis, is a thermally dimorphic fungus that grows as a filamentous mold in the environment and as budding yeast in human tissue. this pathogen is endemic to north america, particularly in the states bordering the mississippi and ohio rivers, the great lakes, and the st. lawrence seaway. infection with b. dermatitidis causes a broad array of clinical manifestations ranging from asymptomatic infection to fulminant sepsis with acute respirato ...201526398538
blastomyces virulence adhesin-1 protein binding to glycosaminoglycans is enhanced by protein disulfide isomerase.blastomyces adhesin-1 (bad-1) protein mediates the virulence of the yeast blastomyces dermatitidis, in part by binding host lung tissue, the extracellular matrix, and cellular receptors via glycosaminoglycans (gags), such as heparan sulfate. the tandem repeats that make up over 90% of bad-1 appear in their native state to be tightly folded into an inactive conformation, but recent work has shown that they become activated and adhesive upon reduction of a disulfide linkage. here, atomic force mic ...201526396244
perianal north american blastomycosis.cutaneous north american blastomycosis most often results from the hematogenous spread of blastomyces dermatitidis following pulmonary infection. cutaneous lesions, which may be either verrucous or ulcerative plaques, commonly occur on or around orifices contiguous to the respiratory tract. we report the case of a 57-year-old man with cutaneous north american blastomycosis who presented with a well-demarcated, firm, moist, verrucous perianal plaque 4 months following the onset of a prolonged upp ...201526367760
fungal dimorphism: the switch from hyphae to yeast is a specialized morphogenetic adaptation allowing colonization of a host.the ability of pathogenic fungi to switch between a multicellular hyphal and unicellular yeast growth form is a tightly regulated process known as dimorphic switching. dimorphic switching requires the fungus to sense and respond to the host environment and is essential for pathogenicity. this review will focus on the role of dimorphism in fungi commonly called thermally dimorphic fungi, which switch to a yeast growth form during infection. this group of phylogenetically diverse ascomycetes inclu ...201526253139
cerebral blastomycosis: radiologic-pathologic correlation of solitary cns blastomycosis mass-like infection.blastomycosis is a fungal infection rarely seen in clinical practice. endemic to the midwestern united states as well as the canadian provinces of manitoba and ontario, blastomyces dermatitidis characteristically involves the skin and lungs. central nervous system (cns) involvement, although a rare complication of this disease, can be fatal. the current literature on cns blastomycosis primarily centers on the spectrum of traditional imaging features of t1- and t2-weighted imaging with which this ...201526167388
could histoplasma capsulatum be related to healthcare-associated infections?healthcare-associated infections (hai) are described in diverse settings. the main etiologic agents of hai are bacteria (85%) and fungi (13%). some factors increase the risk for hai, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. several fungal hai are caused by candida spp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or con ...201526106622
blastomycosis in children: an analysis of clinical, epidemiologic, and genetic features.blastomyces spp. are endemic in regions of the united states and result in blastomycosis, a serious and potentially fatal infection. little is known about the presentation, clinic course, epidemiology, and genetics of blastomycosis in children.201526703241
fungal morphology, iron homeostasis, and lipid metabolism regulated by a gata transcription factor in blastomyces dermatitidis.in response to temperature, blastomyces dermatitidis converts between yeast and mold forms. knowledge of the mechanism(s) underlying this response to temperature remains limited. in b. dermatitidis, we identified a gata transcription factor, sreb, important for the transition to mold. null mutants (srebδ) fail to fully complete the conversion to mold and cannot properly regulate siderophore biosynthesis. to capture the transcriptional response regulated by sreb early in the phase transition (0-4 ...201526114571
the c-type lectin receptor mcl mediates vaccine-induced immunity against infection with blastomyces dermatitidis.c-type lectin receptors (clrs) are essential in shaping the immune response to fungal pathogens. vaccine-induced resistance requires dectin-2 to promote differentiation of antifungal th1 and th17 cells. since dectin-2 and mcl heterodimerize and both clrs use fcrγ as the signaling adaptor, we investigated the role of mcl in vaccine immunity to the fungal pathogen blastomyces dermatitidis. mcl(-/-) mice showed impaired vaccine resistance against b. dermatitidis infection compared to that of wild-t ...201526667836
comparative phylogenomics of pathogenic and nonpathogenic species.the ascomycete onygenales order embraces a diverse group of mammalian pathogens, including the yeast-forming dimorphic fungal pathogens histoplasma capsulatum, paracoccidioides spp. and blastomyces dermatitidis, the dermatophytes microsporum spp. and trichopyton spp., the spherule-forming dimorphic fungal pathogens in the genus coccidioides, and many nonpathogens. although genomes for all of the aforementioned pathogenic species are available, only one nonpathogen had been sequenced. here, we en ...201526613950
anterior cervical corpectomy and fusion for blastomycosis causing destruction of c6 vertebra: a case report.we describe a patient who had cervical spine osteomyelitis caused by blastomyces dermatitidis that resulted in cord compression and cervical spine instability.201526607290
evaluation of an enzyme immunoassay for antibodies to a recombinant blastomyces adhesin-1 repeat antigen as an aid in the diagnosis of blastomycosis in dogs.to evaluate the sensitivity and specificity of an enzyme immunoassay (eia) for antibodies to a recombinant blastomyces adhesin-1 repeat antigen (rbad-1) to aid in the diagnosis of blastomycosis in dogs and compare the findings with results from other tests used for this purpose.201526517616
atypical cutaneous blastomycosis in a child with juvenile idiopathic arthritis on infliximab.blastomyces dermatitidis is a dimorphic fungus endemic to much of north america, particularly the soils of the midwestern and southeastern united states. human infection typically occurs through inhalation of airborne conidia, which can be followed occasionally by dissemination to the skin, bone, genitourinary system, and central nervous system. a hallmark of the pathogen is that it can cause disease in both immunocompetent and immunosuppressed populations. blastomycosis is rare in pediatric pat ...201526482671
calnexin induces expansion of antigen-specific cd4(+) t cells that confer immunity to fungal ascomycetes via conserved epitopes.fungal infections remain a threat due to the lack of broad-spectrum fungal vaccines and protective antigens. recent studies showed that attenuated blastomyces dermatitidis confers protection via t cell recognition of an unknown but conserved antigen. using transgenic cd4(+) t cells recognizing this antigen, we identify an amino acid determinant within the chaperone calnexin that is conserved across diverse fungal ascomycetes. calnexin, typically an er protein, also localizes to the surface of ye ...201525800545
a multiplex quantitative real-time polymerase chain reaction panel for detecting neurologic pathogens in dogs with meningoencephalitis.meningoencephalitis (me) is a common inflammatory disorder of the central nervous system in dogs. clinically, me has both infectious and non-infectious causes. in the present study, a multiplex quantitative real-time polymerase chain reaction (mqpcr) panel was optimized for the detection of eight canine neurologic pathogens (blastomyces dermatitidis, cryptococcus spp., neospora caninum, borrelia burgdorferi, bartonella spp., toxoplasma gondii, ehrlichia canis, and canine distemper virus [cdv]). ...201526040611
systemic blastomycosis in a captive red ruffed lemur (varecia rubra).a 5-yr-old, intact male red ruffed lemur ( varecia rubra ) presented for evaluation as the result of a 1-wk history of lethargy and hyporexia. physical examination findings included thin body condition, muffled heart sounds, harsh lung sounds, and liquid brown diarrhea. complete blood count and serum biochemistry showed an inflammatory leukogram, mild hyponatremia, and mild hypochloremia. orthogonal trunk radiographs revealed a severe alveolar pattern in the right cranial lung lobes with cardiac ...201627691971
mannose receptor is required for optimal induction of vaccine-induced t-helper type 17 cells and resistance to blastomyces dermatitidis infection.we investigated how innate sensing by the mannose receptor (mr) influences the development of antifungal immunity. we demonstrate that mr senses mannan on the surface of attenuated blastomyces dermatitidis vaccine yeast and that mr(-/-) mice demonstrate impaired vaccine immunity against lethal experimental blastomycosis, compared with wild-type control mice. using naive blastomyces-specific transgenic cd4(+) t cells, we found that mr regulates differentiation of naive t cells into t-helper type ...201626931447
fungal mimicry of a mammalian aminopeptidase disables innate immunity and promotes pathogenicity.systemic fungal infections trigger marked immune-regulatory disturbances, but the mechanisms are poorly understood. we report that the pathogenic yeast of blastomyces dermatitidis elaborates dipeptidyl-peptidase iva (dppiva), a close mimic of the mammalian ectopeptidase cd26, which modulates critical aspects of hematopoiesis. we show that, like the mammalian enzyme, fungal dppiva cleaved c-c chemokines and gm-csf. yeast producing dppiva crippled the recruitment and differentiation of monocytes a ...201626922990
blastomyces gilchristii as cause of fatal acute respiratory distress syndrome.since the 2013 description of blastomyces gilchristii, research describing the virulence or clinical outcome of b. gilchristii infection has been lacking. we report molecular evidence of b. gilchristii as an etiologic agent of fatal acute respiratory distress syndrome. b. gilchristii infection was confirmed by pcr and sequence analysis.201626812599
regulation of filamentation in the human fungal pathogen candida tropicalis.the yeast-filament transition is essential for the virulence of a variety of fungi that are pathogenic to humans. n-acetylglucosamine (glcnac) is a potent inducer of filamentation in candida albicans and thermally dimorphic fungi such as histoplasma capsulatum and blastomyces dermatitidis. however, glcnac suppresses rather than promotes filamentation in candida tropicalis, a fungal species that is closely related to c. albicans. despite the intensive study in c. albicans, the regulatory mechanis ...201626466925
cutaneous blastomycosis. an imported case with good response to itraconazole.blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus called blastomyces dermatitidis, which generally produces a pulmonary form of the disease and, to a lesser extent, extra-pulmonary forms such as cutaneous, osteoarticular and genitourinary, among others. cutaneous blastomycosis is the second clinical presentation in frequency. it is considered as primary when it begins by inoculation of the fungus due to traumas, and secondary when the lung fails to contain the infe ...201626422322
pulmonary blastomycosis in a professional diver: an occupational risk.in certain parts of the united states and canada, and northern ontario in particular, the dimorphic fungus blastomyces dermatitidis is endemic and can cause infection in exposed individuals. the site of infection is usually pulmonary, causing respiratory and constitutional symptoms, but can also affect other sites in the body. symptom severity can vary substantially from no symptoms to fatal acute respiratory distress syndrome. the present report describes a 27-year-old professional diver who ha ...201623717820
red fox as sentinel for blastomyces dermatitidis, ontario, canada.blastomyces dermatitidis, a fungus that can cause fatal infection in humans and other mammals, is not readily recoverable from soil, its environmental reservoir. because of the red fox's widespread distribution, susceptibility to b. dermatitidis, close association with soil, and well-defined home ranges, this animal has potential utility as a sentinel for this fungus.201627314650
a conserved dimorphism-regulating histidine kinase controls the dimorphic switching in paracoccidioides brasiliensis.paracoccidioides brasiliensis and p. lutzii, thermally dimorphic fungi, are the causative agents of paracoccidioidomycosis (pcm). paracoccidioides infection occurs when conidia or mycelium fragments are inhaled by the host, which causes the paracoccidioides cells to transition to the yeast form. the development of disease requires conidia inside the host alveoli to differentiate into yeast cells in a temperature-dependent manner. we describe the presence of a two-component signal transduction sy ...201627268997
a few shared up-regulated genes may influence conidia to yeast transformation in dimorphic fungal pathogens.the small number of fungi that commonly cause disease in normal people share the capacity to grow as mycelia in the soil at 25°c and as yeast (or spherules) in mammals at 37°c. this remarkable conversion has long been a topic of interest in medical mycology. the conidia to yeast conversion has been studied by transcription profiling in several fungal species, including histoplasma capsulatum, paracoccidioides brasiliensis, coccidioides spp., blastomyces dermatitidis, and talaromyces marneffei on ...201627118798
in search for equilibrium: immunosuppression versus opportunistic infection.post-transplant immunosuppression is necessary to prevent organ rejection. immunosuppression itself can introduce complications arising from opportunistic infections. we present a case of disseminated blastomycosis manifested only as a skin lesion in an asymptomatic patient post-orthotopic heart transplantation. a 64-year-old female who had recently undergone orthotopic heart transplant for end-stage ischemic cardiomyopathy presented for a scheduled routine cardiac biopsy. the patient had no cur ...201626767088
blastomycosis.blastomycosis is an endemic fungal infection due to blastomyces dermatitidis that most commonly causes pneumonia; but the organism can disseminate to any organ system, most commonly the skin, bones/joints, and genitourinary tract. both immunocompetent and immunocompromised persons can be infected, but more severe disease occurs in the immunocompromised. blastomycosis can be diagnosed by culture, direct visualization of the yeast in affected tissue, and/or antigen testing. treatment course and du ...201626739607
phylogeographic analysis of blastomyces dermatitidis and blastomyces gilchristii reveals an association with north american freshwater drainage basins.blastomyces dermatitidis and blastomyces gilchristii are dimorphic fungal pathogens that cause serious pulmonary and systemic infections in humans. although their natural habitat is in the environment, little is known about their specific ecologic niche(s). here, we analyzed 25 microsatellite loci from 169 strains collected from various regions throughout their known endemic range in north america, representing the largest and most geographically diverse collection of isolates studied to date. g ...201627428521
blastomycosis of the nose: a case report.blastomyces dermatitidis is a thermally dimorphic fungus endemic to the north american soil near the mississippi, ohio, and st. lawrence river valleys, as well as the great lakes basin. it is responsible for blastomycosis, a systemic pyogranulomatous disease. blastomycosis of the head and neck is decidedly uncommon and often mistaken for cancer. there are only 3 previous case reports of blastomycosis presenting as an intranasal lesion. we report the unusual case of a 24-year-old man with blastom ...201627551850
correction: phylogenetic analysis reveals a cryptic species blastomyces gilchristii, sp. nov. within the human pathogenic fungus blastomyces dermatitidis.[this corrects the article doi: 10.1371/journal.pone.0059237.].201627936170
central nervous system blastomycosis in children - a case report and review of the literature.we present a 7-year-old boy with chronic meningitis caused by blastomyces dermatitidis. a review of the literature revealed 32 cases of cns blastomycosis in children between 1983 and 2016, of which 18 represented parenchymal disease of the brain or spinal cord. blastomycosis affecting the cns is rare, but should be considered in children with chronic meningitis.201628033237
an atypical case of mucocutaneous blastomycosis in the greater toronto area.blastomycosis is an uncommon infection caused by blastomyces dermatitidis. while management is fairly straightforward, diagnosis can be quite challenging. we describe a case of a healthy 37-year-old man who presented with progressive mucocutaneous lesions, without lung or other systemic involvement. treatment with itraconazole resulted in complete resolution of signs and symptoms. this case showcases the variety of blastomycosis clinical presentation and the importance of blastomycosis in the di ...201728300442
fludioxonil induces drk1, a fungal group iii hybrid histidine kinase, to dephosphorylate its downstream target, ypd1.novel antifungal drugs and targets are urgently needed. group iii hybrid histidine kinases (hhks) represent an appealing new therapeutic drug target because they are widely expressed in fungi but absent from humans. we investigated the mode of action of the widely utilized, effective fungicide fludioxonil. the drug acts in an hhk-dependent manner by constitutive activation of the hog (high-osmolarity glycerol) pathway, but its mechanism of action is poorly understood. here, we report a new mode ...201727872062
blastomyces dermatitidis serine protease dipeptidyl peptidase iva (dppiva) cleaves elr(+) cxc chemokines altering their effects on neutrophils.blastomycosis elicits a pyogranulomatous inflammatory response, which involves a prominent recruitment of neutrophils to the site of infection. while neutrophils are efficiently recruited to the site of infection, this event is paradoxically coupled with the host's inability to control infection by blastomyces dermatitidis, the causative agent. the mechanisms underlying this characteristic pyogranulomatous response and inability of neutrophils to kill the yeast are poorly understood. we recently ...201728346820
cutaneous blastomycosis and dermatophytic pseudomycetoma in a persian cat from bangkok, thailand.this is a case report of concurrent of blastomycosis and pseudomycetoma in a 3 year-old persian cat from bangkok, thailand. histopathology from antemortem and postmortem samples revealed blastomycosis and dermatophyte pseudomycetoma. the pcr analysis of the formalin-embedded tissue of antemortem sample confirmed that blastomycosis was caused by blastomyces dermatitidis. dermatophyte infection was caused by microsporum canis. according to the author's knowledge, this is the first case of blastomy ...201728116230
usefulness of lymphoid granulomatous inflammation culture obtained by endobronchial ultrasound-guided transbronchial needle aspiration in a fungal endemic area.endobronchial ultrasound-guided transbronchial needle aspiration (ebus-tbna) is the procedure of choice for the evaluation of mediastinal/hilar lymph node enlargements. granulomatous inflammation of the mediastinal/hilar lymph nodes is often identified on routine histology. in addition, mediastinal lymphadenopathy may be present with undiagnosed infection. we sought to determine the usefulness of routine cultures and histology for infectious etiologies in a fungal endemic area when granulomatous ...201727503156
blastomycosis and pregnancy: an unusual postpartum disease course.blastomyces dermatitidis is responsible for systemic mycoses. it is predominantly caused by inhalation of spores and often manifests as pneumonia, which can potentially disseminate; however, direct cutaneous inoculation may also occur. blastomycosis in the perigravid period is exceedingly rare. the partial immunosuppressive state induced by pregnancy can engender more severe infections and is associated with a risk of vertical transmission. published cases describe postpartum symptomatic improve ...201726120305
diagnostic dilemma in primary blastomyces dermatitidis meningitis: role of neurosurgical biopsy.a 52-year-old male on chronic prednisone for polymyalgia rheumatica presented with a subacute history of headaches, nausea, phonophobia, intermittent diplopia and gait instability. he was hospitalized 2 weeks prior to presentation with extensive evaluations only notable for leptomeningeal inflammation on mri. his symptoms progressively worsened and he developed aphasia. he was transferred to our facility where extensive spinal fluid examinations were repeated and were again nondiagnostic. ultima ...201725960731
blastomycosis in northwestern ontario, 2004 to 2014.blastomycosis is an invasive fungal disease caused by blastomyces dermatitidis and the recently discovered blastomyces gilchristii. the medical charts of 64 patients with confirmed cases of blastomycosis in northwestern ontario during a 10-year period (2004 to 2014) were retrospectively reviewed. the number of patients diagnosed with blastomycosis in ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases ...201726600814
pulmonary and sinus fungal diseases in non-immunocompromised patients.the human respiratory tract is exposed daily to airborne fungi, fungal enzymes, and secondary metabolites. the endemic fungi histoplasma capsulatum, coccidioides spp, blastomyces dermatitidis, and paracoccidioides brasiliensis, and occasionally aspergillus fumigatus, are primary pulmonary pathogens of otherwise healthy people. such infections resolve in most people, and only a few infections lead to disease. however, many fungi are directly allergenic by colonising the respiratory tract or indir ...201728774699
blastomyces dermatitidis in a renal transplant recipient: a case report.fungal infections have an important role in organ transplant recipients, and in some cases can be lethal. blastomycosis is rare in kidney transplantation. we present a case of cutaneous blastomycosis in a kidney transplant recipient in tunisia, a country outside the known endemic countries. this case, with the very uncommon and unexpected diagnosis of blastomycosis, demonstrates the diversity of infections in transplant recipients and reflects the importance of histologic and serologic tests in ...201728838445
disseminated blastomycosis mimicking malignancy.blastomycosis is an endemic fungal infection commonly found within the mississippi and ohio river basins and great lakes region. while patients typically present with acute pneumonia, blastomyces dermatitidis has the potential to spread hematogenously, resulting in disseminated infection of multiple organs. in this report, we describe a 57-year-old male with disseminated blastomycosis acquired in south dakota. the diagnostic evaluation was confounded by concern for malignancy given the involveme ...201728813733
severe oculofacial sequelae of cutaneous blastomyces dermatitidis.this study reports a case of blastomyces dermatitidis soft tissue infection resulting in a disfiguring lower eyelid ectropion from cicatricial and postinflammatory cutaneous changes. primary treatment included intravenous amphotericin b followed by long-term oral itraconazole, which resulted in complete remission of the disease without debridement, after which cicatricial ectropion was repaired surgically with scar release, full-thickness skin graft, and temporary frost tarsorraphy. cutaneous bl ...201725098446
cerebral epidural abscess secondary to blastomyces masquerading as an epidermoid tumor.there have been infrequent reports of isolated central nervous system blastomycosis. we report a case of intracranial epidural abscess secondary to blastomyces dermatitidis in a patient residing in rhode island with a history of remote travel to an endemic area. the clinical, radiographic, and pathologic features of this unique case are reviewed.201728721351
approach to fungal infections in human immunodeficiency virus-infected individuals: pneumocystis and beyond.many fungi cause pulmonary disease in patients with human immunodeficiency virus (hiv) infection. pathogens include pneumocystis jirovecii, cryptococcus neoformans, aspergillus spp, histoplasma capsulatum, coccidioides spp, blastomyces dermatitidis, paracoccidioides brasiliensis, talaromyces marneffei, and emmonsia spp. because symptoms are frequently nonspecific, a high index of suspicion for fungal infection is required for diagnosis. clinical manifestations of fungal infection in hiv-infected ...201728797489
clinical manifestations and treatment of blastomycosis.the causal agents of blastomycosis, blastomyces dermatitidis and blastomyces gilchristii, belong to a group of thermally dimorphic fungi that can infect healthy and immunocompromised individuals. following inhalation of mycelial fragments and spores into the lungs, blastomyces spp convert into pathogenic yeast and evade host immune defenses to cause pneumonia and disseminated disease. the clinical spectrum of pulmonary blastomycosis is diverse. the diagnosis of blastomycosis requires a high degr ...201728797487
antifungal activity of the lipophilic antioxidant ferrostatin-1.ferrostatin-1 (fer-1) is a lipophilic antioxidant that effectively blocks ferroptosis, a distinct non-apoptotic form of cell death caused by lipid peroxidation. during many infections, both pathogens and host cells are subjected to oxidative stress, but the occurrence of ferroptosis has not been investigated. ferroptosis was examined in macrophages infected with the pathogenic yeast histoplasma capsulatum. unexpectedly, fer-1 not only reduced death of macrophages infected in vitro, but inhibited ...201728783875
blastomyces dermatitidis peritonitis complicating peritoneal dialysis.fungal peritonitis is an uncommon complication in peritoneal dialysis patients. we report a case of blastomyces dermatitis peritonitis in a nonimmunocompromised peritoneal dialysis patient, who initially presented with symptoms of lower extremity weakness and altered mental status. peritoneal blastomycosis is rare condition and not previously reported in end stage renal disease patients on peritoneal dialysis. fungal peritonitis can present with subtle clinical findings so a high index of suspic ...201728628236
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