{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T13:03:37Z","timestamp":1771419817147,"version":"3.50.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Blastomycosis is a dimorphic fungal infection caused by\n                    <jats:italic>Blastomyces dermatitidis<\/jats:italic>\n                    and related species, classically presenting with pulmonary and cutaneous involvement. Musculoskeletal manifestations, particularly monoarthritis, are rare and diagnostically challenging. We present the case of a previously healthy 41-year-old man who developed nodular skin lesions, cough, pulmonary nodules and persistent left knee arthritis, initially thought to be due to pseudogout. The diagnosis of disseminated fungal infection was suggested by CT scan, skin biopsy, and confirmatory fungal culture that grew\n                    <jats:italic>Blastomyces dermatitidis.<\/jats:italic>\n                    This case highlights the atypical pattern of joint involvement, the need to expand the differentials as dictated by clinical signs, the role of multidisciplinary collaboration, and the diagnostic utility of skin biopsy and fungal culture.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1704751","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:10:54Z","timestamp":1771416654000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cutaneous clues to a fungal culprit: disseminated Blastomycosis presenting as inflammatory monoarthritis \u2014 a Case Report"],"prefix":"10.3389","volume":"13","author":[{"given":"Paddy","family":"Ssentongo","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Department of Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zinaida","family":"Perciuleac","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Department of Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtland","family":"Kaye","sequence":"additional","affiliation":[{"name":"College of Medicine, Penn State University","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rekha Aley","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Radiology, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Garrett","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley","family":"Albano-Aluquin","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas N.","family":"Helm","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie J.","family":"Parent","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Department of Medicine, Penn State Hershey Medical Center","place":["Hershey, PA, United States"]},{"name":"College of Medicine, Penn State University","place":["Hershey, PA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1086\/588300","article-title":"Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America","volume":"46","author":"Chapman","year":"2008","journal-title":"Clin Infect 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