What is Deep Blastomycosis?
There are two types – deep blastomycosis of Jill Krast (North American blastomycosis) and deep blastomycosis of Busse-Bushke (European blastomycosis, cryptococcosis, torulosis).
Gilkrayst Deep Blastomycosis
This is a chronic infectious non-contagious disease. It affects mainly the skin, bones, lungs, liver, spleen, and kidneys. The entry gate for this infection is the skin and respiratory tract. The disease has two forms: primary skin and systemic (visceral).
Primary skin lesions are manifested in the form of papular rashes of a reddish color, which are located on the skin of the face, limbs, buttocks. They merge with each other, pustules with purulent crusts and ulcerations form on their surface. Increasing, they form large ulcerative plaques with granulations and a scarring center. They differentiate the disease with syphilitic gum, leishmaniasis, verrucous tuberculosis, chronic vegetative pyoderma and other deep mycoses. The diagnosis is confirmed by microscopic and cultural studies, as well as skin tests with a blastomycete vaccine and complement fixation reaction.
Deep blastomycosis Busse-Buschke
Systemic disease with damage to the meninges. The lungs, spleen, kidneys, liver, skin and mucous membranes can also be affected. The skin is rarely affected, manifested by multiple acne-like papules, subcutaneous nodes in the form of gum and subcutaneous abscesses. There are foci of ulceration with deep crater-like ulcers, the bottom of which is covered with flaccid granulations with mucopurulent discharge and thick crusts. In the future, ulcers turn into inverted scars.
Diagnosis of Deep Blastomycosis
The diagnosis is based on histological detection in the foci of the elements of the fungus and the selection of the culture of the fungus in a cultural study. Differentiate with gummous syphilis, chronic vegetative pyoderma, warty tuberculosis, sporotrichosis.
Treatment of Deep Blastomycosis
It is carried out by nystatin or levorin for 3-4 weeks in large doses. Massive doses of iodine are used. Amphotericin B is infused intravenously in a 5% glucose solution, antibiotics of a wide spectrum of action, sulfonamides, hemotherapy, and vitamin preparations are used. External – 1-2% aqueous and alcoholic solutions of aniline dyes, Lugol’s solution, Castellani liquid, levorin ointment, etc.