Fungal Infections

Blastomycosis is a rare fungal infection that commonly involves the lungs and skin. Acute blastomycosis can resolve spontaneously without treatment; however, antifungal treatment can hasten recovery. Treatment of choice is itraconazole 200-400 mg daily for 6-12 months, and severe pulmonary or disseminated blastomycosis is treated with IV amphotericin B followed by an oral azole.

Coccidioidomycosis is caused by the highly infectious, dimorphic fungus Coccidioides immitis. The broad clinical presentation of coccidioidomycosis was appreciated in the 1930s, when it was identified as the etiologic pathogen of “Valley fever” in the San Joaquin Valley in California. Cutaneous involvement is generally secondary to disseminated disease but can represent primary disease from direct inoculation. Systemic involvement, especially in immunocompromised hosts, has a poor prognosis, warranting timely diagnosis and prompt management.

This ongoing feature series was taken from the 4th annual postgraduate course and workshop in medical mycology-dermatomycology, July 27-30, 1979, Newport Beach, CA. Cryptococcosis is a deep cutaneous mycotic infection caused by the opportunistic organism Cryptococcus neoformans. This encapsulated budding yeast is isolated from pigeon droppings and contaminated soil worldwide.

This ongoing feature series was taken from the 4th annual postgraduate course and workshop in medical mycology-dermatomycology, July 27-30, 1979, Newport Beach, CA. This month's case is sporotrichosis, a disease classically known as rose gardener's disease, as the infection can result after being pricked by a contaminted rose thorn.

Sporotrichosis is a deep cutaneous mycotic infection caused by the dimorphic organism Sporothrix schenckii (Figure 1).

This ongoing feature series was taken from the 4th annual postgraduate course and workshop in medical mycology-dermatomycology, July 27-30, 1979, Newport Beach, CA.

Botryomycosis is a chronic purulent and granulomatous bacterial infection of the skin and occasionally the internal organs in which tissue granules are formed, simulating those seen in actinomycosis, nocardiosis and maduromycosis.¹

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Taken from the 4th annual postgraduate course and workshop in medical mycology-dermatomycology, July 27-30, 1979, Newport Beach, CA.

Dr. James H. Graham was the former head of dermatopathology at the Armed Forces Institute of Pathology and the former chair of dermatology at UC-Irvine.