Blastomycosis

Prognosis

Although unrecognized and untreated blastomycosis can be a fatal disease, the prognosis for treated blastomycosis is quite good, with most symptoms and radiologic 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.[52]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 serologic and skin antigen testing. However, this specific immunity is not necessarily protective, and reinfection can occur in the face of repeated exposure.