BLASTOMYCOSIS AS AN ETIOLOGY OF ACUTE LUNG INJURY

Blastomyces dermatitidis, a dimorphic broad-based budding; yeast endem ic to the Mississippi River Valley region, is responsible for morbidit y in humans via inhalation and dissemination, The response of acute lu ng injury, which produces an illness with serious morbidity and an app roximately 50% mortality, uncommonly occurs. Diagnosis can be difficul t, and a high index of suspicion should be maintained in endemic regio ns for patients with acute lung injury of uncertain etiology, especial ly if their condition deteriorates on broad-spectrum antimicrobial and antitubercular therapy and they have a previous insidious respiratory complaint and constitutional symptoms. Diagnosis should be aggressive ly pursued and treatment with amphotericin B (0.6 to 0.8 mg /kg/day) i nitiated as early as possible.