Blastomycosis - US endemic areas 

Blastomyces lives in the environment, particularly in moist soil and in decomposing organic matter such as wood and leaves. In the United States, the fungus mainly lives in the midwestern, south-central, and southeastern states, particularly in areas surrounding the Ohio and Mississippi River valleys, the Great Lakes, and the Saint Lawrence River and has been creeping into the Northeast. The fungus also lives in Canada,and a small number of blastomycosis cases have been reported from Africa and India (CDC website).

Blastomyces lives in the environment as a mold that produces fungal spores. When animals breathe in the spores, they are at risk for developing blastomycosis. After the spores enter the lungs, the body temperature allows the spores to transform into yeast. The yeast can stay in the lungs or spread through the bloodstream to other parts of the body, such as the skin, bones and joints, organs, and central nervous system (brain and spinal cord). It is always on the differential list in the hot bed regions is patients with pulmonary infiltrates or intra-thoracic lymphadenopathy.

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