Danilo D., a dermatologist in Chicago, used VisualDx to create a better differential, compare compare the patient’s nodule to VisualDx’s image library, and find the appropriate treatment for the patient.
“Patient with expanding hyperkeratotic round nodule on thigh for 3 months. Went to primary provider without improvement for a few weeks, tried a few topical creams without improvement, and finally made it to dermatology. Looked at VisualDx and compared some of the images based on the differential builder – and saw a mirror image of our patient’s lesion and helped us decide a better differential diagnosis. We biopsied at the lesion and it came back supporting exactly what we thought: blastomycosis. Patient was started on appropriate therapy and the lesions began to resolve. A wonderful case with the wonderful outcome using a wonderful app.”
What is blastomycosis?
Blastomycosis, also known as Gilchrist disease and North American blastomycosis, is an infection caused by the dimorphic fungus Blastomyces dermatitidis, a soil organism endemic to much of North America. Other foci have been reported from Southern Africa, the Middle East, and India. Infection can involve almost any organ in the body, although the most commonly involved sites are the lungs, followed by the skin, bones, and genitourinary tract.
What should we be aware of when making a diagnosis?
Patients should be questioned if they have a pet dog that has recently been infected or sick.
How can we treat this?
Treatment recommendations from the Infectious Diseases Society of America (IDSA) vary based on severity and include antifungals such as amphotericin B and itraconazole.
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