{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:41:02Z","timestamp":1791265262327,"version":"4.1.0"},"reference-count":92,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T00:00:00Z","timestamp":1673654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Blastomycosis is caused by a thermally dimorphic fungus that thrives in moist acidic soil. Blastomyces dermatitidis is the species responsible for most infections in North America and is especially common in areas around the Great Lakes, the St. Lawrence Seaway, and in several south-central and southeastern United States. Other Blastomyces species have more recently been discovered to cause disease in distinct geographic regions around the world. Infection almost always occurs following inhalation of conidia produced in the mold phase. Acute pulmonary infection ranges from asymptomatic to typical community-acquired pneumonia; more chronic forms of pulmonary infection can present as mass-like lesions or cavitary pneumonia. Infrequently, pulmonary infection can progress to acute respiratory distress syndrome that is associated with a high mortality rate. After initial pulmonary infection, hematogenous dissemination of the yeast form of Blastomyces is common. Most often this is manifested by cutaneous lesions, but osteoarticular, genitourinary, and central nervous system (CNS) involvement also occurs. The diagnosis of blastomycosis can be made by growth of the mold phase of Blastomyces spp. in culture or by histopathological identification of the distinctive features of the yeast form in tissues. Detection of cell wall antigens of Blastomyces in urine or serum provides a rapid method for a probable diagnosis of blastomycosis, but cross-reactivity with other endemic mycoses commonly occurs. Treatment of severe pulmonary or disseminated blastomycosis and CNS blastomycosis initially is with a lipid formulation of amphotericin B. After improvement, therapy can be changed to an oral azole, almost always itraconazole. With mild to moderate pulmonary or disseminated blastomycosis, oral itraconazole treatment is recommended.<\/jats:p>","DOI":"10.3390\/jof9010117","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T01:31:15Z","timestamp":1673832675000},"page":"117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Blastomycosis: A Review of Mycological and Clinical Aspects"],"prefix":"10.3390","volume":"9","author":[{"given":"Kathleen A.","family":"Linder","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA"},{"name":"Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Kauffman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA"},{"name":"Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa H.","family":"Miceli","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/mmy.38.s1.67.77","article-title":"Clues to the presence of pathogenic fungi in certain environments","volume":"38","author":"Restrepo","year":"2000","journal-title":"Med. Mycol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11046-006-0018-9","article-title":"Geographic distribution of human blastomycosis cases in Milwaukee, Wisconsin, USA: Association with urban watersheds","volume":"161","author":"Baumgardner","year":"2006","journal-title":"Mycopathologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1056\/NEJM198602273140901","article-title":"Isolation of Blastomyces dermatitidis in soil associated with a large outbreak of blastomycosis in Wisconsin","volume":"314","author":"Klein","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1093\/clinids\/13.5.898","article-title":"An outbreak of human and canine blastomycosis","volume":"3","author":"Baumgardner","year":"1991","journal-title":"Rev. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1580\/1080-6032(2002)013[0250:AOOBOA]2.0.CO;2","article-title":"An outbreak of blastomycosis on a United States Indian reservation","volume":"13","author":"Baumgardner","year":"2002","journal-title":"Wilderness Environ. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3121\/cmr.2010.958","article-title":"Non-rural point source blastomycosis outbreak near a yard waste collection site","volume":"9","author":"Pfister","year":"2011","journal-title":"Clin. Med. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1378\/chest.10-0627","article-title":"Blastomycosis in Indiana: Digging up more cases","volume":"138","author":"Carlos","year":"2010","journal-title":"Chest"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/infdis\/155.3.568","article-title":"Common-source outbreak of blastomycosis in hunters and their dogs","volume":"155","author":"Armstrong","year":"1987","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/cid\/cit366","article-title":"A large community outbreak of blastomycosis in Wisconsin with geographic and ethnic clustering","volume":"57","author":"Roy","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e01224-19","DOI":"10.1128\/mBio.01224-19","article-title":"Investigation of genetic susceptibility to blastomycosis reveals interleukin-6 as a potential susceptibility locus","volume":"10","author":"Merkhofer","year":"2019","journal-title":"mBio"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1093\/mmy\/myu051","article-title":"Canine blastomycosis in Wisconsin: A survey of small animal veterinary practices","volume":"52","author":"Anderson","year":"2014","journal-title":"Med. Mycol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1093\/mmy\/myz110","article-title":"Prevalence, distribution, and risk factors for canine blastomycosis in Michigan, USA","volume":"58","author":"Shelnutt","year":"2020","journal-title":"Med. Mycol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s13225-018-0403-y","article-title":"Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis","volume":"90","author":"Jiang","year":"2018","journal-title":"Fungal Divers."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Brown, E.M., McTaggart, L.R., Zhang, S.X., Low, D.E., Stevens, D.A., and Richardson, S.E. (2013). Phylogenetic analysis reveals a cryptic species Blastomyces gilchristii sp. nov. within the human pathogenic fungus Blastomyces dermatitidis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0059237"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1560","DOI":"10.1093\/cid\/ciaa1100","article-title":"Blastomycosis in Africa and the Middle East: A comprehensive review of reported cases and reanalysis of historical isolates based on molecular data","volume":"73","author":"Schwartz","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e01661-19","DOI":"10.1128\/JCM.01661-19","article-title":"Human blastomycosis in South Africa caused by Blastomyces percursus and Blastomyces emzantsi sp. nov., 1967 to 2014","volume":"58","author":"Maphanga","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/BF00468081","article-title":"Blastomycosis: Report of the first case from Alberta, Canada","volume":"79","author":"Sekhon","year":"1982","journal-title":"Mycopathologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/cid\/ciy483","article-title":"Blastomyces helicus, a new dimorphic fungus causing fatal pulmonary and systemic disease in humans and animals in western Canada and the United States","volume":"68","author":"Schwartz","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Schwartz, I.S., Kenyon, C., Feng, P., Govender, N.P., Gukik, K., Sigler, L., Jiang, Y., Stielow, J.B., Munoz, J.F., and Cuomo, C.A. (2015). 50 years of Emmonsia disease in humans: The dramatic emergence of a cluster of novel fungal pathogens. PLoS Pathog., 11.","DOI":"10.1371\/journal.ppat.1005198"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1055\/s-0039-3400281","article-title":"Blastomycosis","volume":"41","author":"Schwartz","year":"2020","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.mmcr.2016.09.002","article-title":"Evidence of delayed dissemination or re-infection with Blastomyces in two immunocompetent hosts","volume":"13","author":"Anderson","year":"2016","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"174","DOI":"10.4103\/atm.ATM_86_20","article-title":"Pulmonary blastomycosis in rural Upstate New York: A case series and review of literature","volume":"15","author":"Bethuel","year":"2020","journal-title":"Ann. Thorac. Med."},{"key":"ref_23","first-page":"219","article-title":"Endemic blastomycosis in Mississippi: Epidemiological and clinical studies","volume":"12","author":"Chapman","year":"1997","journal-title":"Semin. Respir. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1580\/1080-6032(2004)015[0250:SOPBNW]2.0.CO;2","article-title":"Symptoms of pulmonary blastomycosis: Northern Wisconsin, United States","volume":"15","author":"Baumgardner","year":"2004","journal-title":"Wilderness Environ. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1155\/2009\/763018","article-title":"Computed tomographic scan evaluation of pulmonary blastomycosis","volume":"20","author":"Ronald","year":"2009","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.mmcr.2020.03.006","article-title":"Pulmonary blastomycosis: A case series and review of unique radiological findings","volume":"28","author":"Maini","year":"2020","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e3538","DOI":"10.1097\/MD.0000000000003538","article-title":"Management and outcomes of acute respiratory distress syndrome caused by blastomycosis","volume":"95","author":"Schwartz","year":"2016","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1056\/NEJM199310213291704","article-title":"Overwhelming pulmonary blastomycosis associated with the adult respiratory distress syndrome","volume":"329","author":"Meyer","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1093\/cid\/ciaa294","article-title":"Outcomes with severe blastomycosis and respiratory failure in the United States","volume":"72","author":"Rush","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1007\/s11908-013-0352-2","article-title":"Cutaneous manifestations of endemic mycoses","volume":"15","author":"Smith","year":"2013","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.jemermed.2017.09.034","article-title":"Primary cutaneous blastomycosis after inoculation from a woodworking blade","volume":"54","author":"Ladizinski","year":"2018","journal-title":"J. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1086\/339957","article-title":"Cutaneous inoculation blastomycosis","volume":"34","author":"Gray","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1007\/s10096-014-2149-0","article-title":"Dimorphic fungal osteoarticular infections","volume":"33","author":"Rammaert","year":"2014","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e237688","DOI":"10.1136\/bcr-2020-237688","article-title":"Osseous blastomycosis mimicking malignancy","volume":"13","author":"Kouba","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e0008619","DOI":"10.1128\/cmr.00086-19","article-title":"International Consortium for Osteoarticular Mycoses. Osteoarticular mycoses","volume":"35","author":"Gamaletsou","year":"2022","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kauffman, C.A. (2019). Central nervous system infection with other endemic mycoses: Rare manifestation of blastomycosis, paracoccidioidomycosis, talaromycosis, and sporotrichosis. J. Fungi, 5.","DOI":"10.3390\/jof5030064"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kauffman, C.A., Pappas, P.G., Sobel, J.D., and Dismukes, W.E. (2011). Blastomycosis. Essentials of Clinical Mycology, Springer. [2nd ed.].","DOI":"10.1007\/978-1-4419-6640-7"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of invasive fungal disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium","volume":"71","author":"Donnelly","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1128\/CMR.00056-09","article-title":"Clinical and laboratory update on blastomycosis","volume":"23","author":"Saccente","year":"2010","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1378\/chest.121.3.768","article-title":"Pulmonary blastomycosis: An appraisal of diagnostic techniques","volume":"121","author":"Martynowicz","year":"2002","journal-title":"Chest"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1128\/jcm.32.4.867-870.1994","article-title":"Comparative evaluation of chemiluminescent DNA probe assays and exoantigen tests for rapid identification of Blastomyces dermatitidis and Coccidioides immitis","volume":"32","author":"Padhye","year":"1994","journal-title":"J. Clin. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4873","DOI":"10.1128\/JCM.42.10.4873-4875.2004","article-title":"Antigen assay with the potential to aid in diagnosis of blastomycosis","volume":"42","author":"Durkin","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1128\/CVI.05248-11","article-title":"Blastomyces dermatitidis antigen detection by quantitative enzyme immunoassay","volume":"19","author":"Connolly","year":"2012","journal-title":"Clin. Vacc. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/MCP.0b013e3283447b60","article-title":"Antigen detection in bronchoalveolar lavage fluid for diagnosis of fungal pneumonia","volume":"17","author":"Hage","year":"2011","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.rmed.2006.04.017","article-title":"Diagnosis of pulmonary histoplasmosis and blastomycosis by detection of antigen in bronchoalveolar lavage fluid using an improved second-generation enzyme-linked immunoassay","volume":"101","author":"Hage","year":"2007","journal-title":"Respir. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1086\/650579","article-title":"Blastomycosis of the central nervous system: A multicenter review of diagnosis and treatment in the modern era","volume":"50","author":"Bariola","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.diagmicrobio.2010.09.015","article-title":"Detection of Blastomyces dermatitidis antigen in patients with newly diagnosed blastomycosis","volume":"69","author":"Bariola","year":"2011","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3660","DOI":"10.1128\/JCM.02352-15","article-title":"Blastomyces antigen detection for diagnosis and management of blastomycosis","volume":"53","author":"Frost","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3109\/13693786.2011.608172","article-title":"Cross-reactivity in the Platelia Aspergillus enzyme immunoassay caused by blastomycosis","volume":"50","author":"Lewis","year":"2012","journal-title":"Med. Mycol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.diagmicrobio.2007.04.022","article-title":"Cross-reactivity of non-Aspergillus fungal species in the Aspergillus galactomannan enzyme immunoassay","volume":"59","author":"Cummings","year":"2007","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"89059","DOI":"10.1155\/2007\/89059","article-title":"Blastomyces antigen detection for monitoring progression of blastomycosis in a pregnant adolescent","volume":"2007","author":"Tarr","year":"2007","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1097\/01.inf.0000241144.89426.2a","article-title":"Urine antigen detection of blastomycosis in pediatric patients","volume":"25","author":"Mongkolrattanothai","year":"2006","journal-title":"Ped. Infect. Dis. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/jvim.12306","article-title":"Serum and urine Blastomyces antigen concentrations as markers of clinical remission in dogs treated for systemic blastomycosis","volume":"28","author":"Foy","year":"2014","journal-title":"J. Vet. Intern. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/infdis\/155.2.262","article-title":"Serological tests for blastomycosis: Assessments during a large point-source outbreak in Wisconsin","volume":"155","author":"Klein","year":"1987","journal-title":"J. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/clinids\/19.1.87","article-title":"Utility of anti-WI-1 serological testing in the diagnosis of blastomycosis in Wisconsin residents","volume":"19","author":"Soufleris","year":"1994","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1172\/JCI114406","article-title":"Isolation, purification, and radiolabeling of a novel 120-kD surface protein on Blastomyces dermatitidis yeasts to detect antibody in infected patients","volume":"85","author":"Klein","year":"1990","journal-title":"J. Clin. Investig."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1128\/CVI.00597-13","article-title":"Development of a highly sensitive and specific blastomycosis antibody enzyme immunoassay using Blastomyces dermatitidis surface protein BAD-1","volume":"21","author":"Richer","year":"2014","journal-title":"Clin. Vacc. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.2460\/javma.247.10.1133","article-title":"Evaluation of an enzyme immunoassay for antibodies to a recombinant Blastomyces adhesin-1 repeat antigen as an aid in the diagnosis of blastomycosis in dogs","volume":"247","author":"Mourning","year":"2015","journal-title":"JAVMA"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"02078-20","DOI":"10.1128\/JCM.02078-20","article-title":"Development of a duplex real-time PCR assay for the differentiation of Blastomyces dermatitidis and Blastomyces gilchristii and a retrospective analysis of culture and primary specimens from blastomycosis cases from New York (2005\u20132019)","volume":"59","author":"Kaplan","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1128\/JCM.00310-12","article-title":"Real-time PCR assay for identification of Blastomyces dermatitidis in culture and in tissue","volume":"50","author":"Sidamonidze","year":"2012","journal-title":"J. Clin. Microbiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1128\/JCM.41.1.205-208.2003","article-title":"Nested PCR assays for detection of Blastomyces dermatitidis DNA in paraffin-embedded canine tissue","volume":"41","author":"Bialek","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1080\/13693780600954749","article-title":"PCR-based detection of DNA from the human pathogen Blastomyces dermatitidis from natural soil samples","volume":"44","author":"Burgess","year":"2006","journal-title":"Med. Mycol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3204","DOI":"10.1128\/JCM.00673-11","article-title":"Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR","volume":"49","author":"Babady","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_64","doi-asserted-by":"crossref","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. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/0002-9343(92)90575-V","article-title":"Itraconazole therapy for blastomycosis and histoplasmosis","volume":"9","author":"Dismukes","year":"1992","journal-title":"Am. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1086\/605499","article-title":"Toxicodynamics of itraconazole: Implications for therapeutic drug monitoring","volume":"49","author":"Lestner","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1378\/chest.07-2778","article-title":"Corticosteroids for blastomycosis-induced ARDS: A report of two patients and review of the literature","volume":"133","author":"Lahm","year":"2008","journal-title":"Chest"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1086\/653429","article-title":"Corticosteroids as adjunctive therapy in severe blastomycosis-induced acute respiratory distress syndrome in an immunosuppressed patient","volume":"51","author":"Plamondon","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/cc349","article-title":"Extracorporeal membrane oxygenation for overwhelming Blastomyces dermatitidis pneumonia","volume":"3","author":"Dalton","year":"1999","journal-title":"Crit. Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s12630-015-0378-z","article-title":"Extracorporeal membrane oxygenation for blastomycosis-related acute respiratory distress syndrome: A case series","volume":"62","author":"Bednarczyk","year":"2015","journal-title":"Can. J. Anaesth."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1177\/0267659119844391","article-title":"Veno-venous extracorporeal life support for blastomycosis-associated acute respiratory distress syndrome","volume":"34","author":"Fan","year":"2019","journal-title":"Perfusion"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e239498","DOI":"10.1136\/bcr-2020-239498","article-title":"Blastomycosis with rapid-onset acute respiratory distress syndrome in an urban setting","volume":"14","author":"Agarwal","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/ajhp\/zxz054","article-title":"Apparent interference with extracorporeal membrane oxygenation by liposomal amphotericin B in a patient with disseminated blastomycosis receiving continuous renal replacement therapy","volume":"76","author":"Branick","year":"2019","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"5271","DOI":"10.1128\/AAC.00394-13","article-title":"Quantification of brain voriconazole levels in healthy adults using fluorine magnetic resonance spectroscopy","volume":"57","author":"Henry","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1345\/aph.1M010","article-title":"The role of voriconazole in the treatment of central nervous system blastomycosis","volume":"43","author":"Ta","year":"2009","journal-title":"Ann. Pharmacother."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1080\/13693780600803870","article-title":"Cerebral blastomycosis: A case series incorporating voriconazole in the treatment regimen","volume":"44","author":"Borgia","year":"2006","journal-title":"Med. Mycol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"S202","DOI":"10.1093\/ofid\/ofaa439.454","article-title":"MSG-15: Pharmacokinetic, adverse events, and tolerability data from an open label randomized clinical trial comparing oral suba-itraconazole to conventional itraconazole for treatment of endemic mycosis","volume":"7","author":"Pappas","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/clinids\/20.2.267","article-title":"Treatment of blastomycosis with fluconazole: A pilot study","volume":"20","author":"Pappas","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1086\/514539","article-title":"Treatment of blastomycosis with higher doses of fluconazole","volume":"25","author":"Pappas","year":"1997","journal-title":"Clin. Infect. Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e00885-18","DOI":"10.1128\/AAC.00885-18","article-title":"Population pharmacokinetics and cerebrospinal fluid penetration of fluconazole in adults with cryptococcal meningitis","volume":"62","author":"Stott","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1128\/AAC.01148-07","article-title":"Voriconazole use for endemic fungal infections","volume":"53","author":"Freifeld","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1086\/524669","article-title":"Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes","volume":"46","author":"Pascual","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"4029","DOI":"10.1128\/AAC.00359-12","article-title":"Successful use of posaconazole for treatment of blastomycosis","volume":"56","author":"Proia","year":"2012","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s12281-017-0281-x","article-title":"Treatment of the midwestern endemic mycoses, blastomycosis and histoplasmosis","volume":"11","author":"Kauffman","year":"2017","journal-title":"Curr. Fungal Infect. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s40265-020-01306-y","article-title":"Pharmacokinetics and pharmacodynamics of posaconazole","volume":"80","author":"Chen","year":"2020","journal-title":"Drugs"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1002\/phar.1328","article-title":"Posaconazole therapeutic drug monitoring in the real-life setting: A single-center experience and review of the literature","volume":"33","author":"Gross","year":"2013","journal-title":"Pharmacotherapy"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1093\/cid\/ciw305","article-title":"Isavuconazole treatment of cryptococcosis and dimorphic mycoses","volume":"63","author":"Thompson","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e0017722","DOI":"10.1128\/aac.00177-22","article-title":"New perspectives on antimicrobial agents: Isavuconazole","volume":"66","author":"Lewis","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Wiederhold, N.P. (2020). Review of the novel investigational antifungal Olorofim. J. Fungi, 6.","DOI":"10.3390\/jof6030122"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/00005792-199309000-00003","article-title":"Blastomycosis in immunocompromised patients","volume":"72","author":"Pappas","year":"1993","journal-title":"Medicine"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/j.1399-3062.2007.00227.x","article-title":"Blastomycosis in solid organ transplant recipients","volume":"9","author":"Gauthier","year":"2007","journal-title":"Transpl. Infect. Dis."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1399-3062.2011.00658.x","article-title":"A multicenter study of histoplasmosis and blastomycosis after solid organ transplantation","volume":"14","author":"Grim","year":"2012","journal-title":"Transpl. Infect. Dis."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/9\/1\/117\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:06:09Z","timestamp":1760119569000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/9\/1\/117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,14]]},"references-count":92,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jof9010117"],"URL":"https:\/\/doi.org\/10.3390\/jof9010117","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,14]]}}}