North American blastomycosis

Abstract

North American blastomycosis (Gilchrist's disease) in a granulomatous, infectious disease caused by the fungus, Blastomyces dermatitidis (Gilchrist and Stokes, 1898). The malady, in its cutaneous form, was first described by Gilchrist1 in 1894. A few years later, together with Stokes, he was able to isolate and culture that causative organisms which he designated as B. dermatitibis.23 The first description of the disease in its systemic form was made by Walker and Montgomery4 in 1902.The first reports by Gilchrist were followed by an era of confusion during which the disease was confounded with other entities, particularly cryptococcosis and candidiasis, all caused by morphologically similar budding organisms. Nineteen new names were suggested for the causative fungus. During the last two decades, however, a clearer picture of the disease process has emerged, particularly as a result of studies by the Duke Medical School group, headed by Smith, Martin, and Conant. Numerous clinical and laboratory reports have contributed significantly to a fuller understanding of the disease, but there are still some fundamental question to be answered. Excellent review articles on North American blastomycosis are available.