Blastomycosis

Prognosis

Although unrecognised and untreated blastomycosis can be a fatal disease, the prognosis for treated blastomycosis is quite good, with most symptoms and radiological manifestations responding quickly to appropriate antifungal therapy. Overall mortality associated with blastomycosis is 6.6%, although the risk is increased in patients who develop acute respiratory distress syndrome, have disseminated disease, or are immunosuppressed.[50]Carignan A, Denis M, Abou Chakra CN. Mortality associated with Blastomyces dermatitidis infection: a systematic review of the literature and meta-analysis. Med Mycol. 2020 Jan 1;58(1):1-10. https://www.doi.org/10.1093/mmy/myz048 http://www.ncbi.nlm.nih.gov/pubmed/31111911?tool=bestpractice.com

Relapse

If undertreated, blastomycosis has a high rate of relapse, which is the primary factor in the prolonged treatment courses lasting 6 to 12 months. Infection with Blastomyces dermatitidis does lead to the development of lasting specific cell-mediated and humoral immunity, as evidenced by the ability to perform serological and skin antigen testing. However, this specific immunity is not necessarily protective, and re-infection can occur in the face of repeated exposure.