Over the past decades, the significance of antifungal drug discovery to the practice of modern medicine has increased rapidly. The number of therapeutic methods for the treatment of fungal infections is quite limited as compared with those available to treat bacterial infections. As always focused on the research highlights, Creative Biolabs now provides a full series of antifungal drug discovery services against various fungal infections, including blastomycosis.
What is Blastomycosis?
Blastomycosis, which is also known as "North American blastomycosis", "blastomycetic dermatitis", or "Gilchrist's disease", is an endemic mycosis, especially in the central United States. This disease is caused by inhaling spores of the dimorphic fungus, Blastomyces dermatitidis, which exists in nature in the mycelial phase and turns into yeast phase at body temperature. This fungus can infect both humans and other animals, particularly dogs and occasionally cats. It may cause epidemics of infection following a point source of infection or sporadic endemic infection. Blastomycosis can be regarded as a subclinical illness with following protection against progressive infection provided by cellular immune mechanisms. However, it may exist with the progressive disease of either pulmonary or extrapulmonary disease or both.
Fig.1 Pathogenesis of blastomycosis. (Castillo, 2016)
The Symptoms of Blastomycosis
Blastomycosis is commonly a pulmonary disease caused by inhaling spores of B. dermatitidis; however, the fungi occasionally spread hematogenously, leading to extrapulmonary disease. The clinical symptoms of blastomycosis are highly variable. The general nonspecific complaints include malaise, fatigue, weight loss, and fever. The specific symptoms of blastomycosis in different infection model are as follows:
The presentation of clinical blastomycosis for most patients is pneumonia along with an alveolar or mass-like infiltrate displayed by radiography. The next most frequent pattern of presentations is miliary or reticulonodular types. Pulmonary blastomycosis might be asymptomatic or cause an acute, self-limited disease which generally goes unrecognized. It can also begin insidiously and develop into a chronic, progressive infection. The symptoms include a productive or dry hacking cough, chills, fever, chest pain, dyspnea, and drenching sweats. Occasionally, there occurs pleural effusion.
In extrapulmonary disseminated blastomycosis, symptoms depend on the organ involved. Cutaneous lesions are the next most common manifestation of blastomycosis following pneumonia, which is either verrucous or ulcerative. Osteomyelitis caused by B. dermatitidis infection is found in as many as one-fourth of extrapulmonary infection cases. Granuloma, suppuration, or necrosis may be found in the bone biopsy. The genitourinary system is consistent with lung, skin, and bone in frequency of involvement. And prostatitis and epididymoorchitis have been reported most frequently. CNS (central nervous system) involvement can display as brain abscess, epidural abscess, or meningitis.
Diagnosis and Treatment of Blastomycosis
Regarding the diagnosis of blastomycosis, it is relatively easy to identify the fungus in exudate or tissue. Either seeing the organism or growing B. dermatitidis is reliable for an accurate diagnosis. Since colonization with B. dermatitidis does not occur, detection of the fungus by culture or histology is able to confirm the diagnosis of infection.
Spontaneous resolution of chronic blastomycosis is extremely rare, and untreated blastomycosis can be related to mortality rates of almost 60%. All patients with chronic pulmonary and extrapulmonary blastomycosis should get antifungal treated. The antifungal treatment of blastomycosis has been achieved through the development of the azoles.
Antifungal Drug Discovery for Blastomycosis at Creative Biolabs
Aided by the world-class technology and advanced facilities, scientists at Creative Biolabs devote themselves to providing the most comprehensive series of antifungal drug discovery services for our worldwide clients. In addition to blastomycosis, we also provide potential antifungal drug discovery services against other fungal diseases, which including but not limited to:
If you are interested in the fungal disease we investigate, please click the links above. For more detailed information, just feel free to contact us.
Reference
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