Internal Medicine

0521779407-B01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:52

Blastocystis Hominis Infection Blastomyces Dermatitidis 243

General Measures

■None

specific therapy

Indications

■A symptomatic patient in whom no other cause of diarrhea can be

found (after proper search) can be treated empirically (no treatment

trials yet published).

Treatment Options

■Metronidazole for 10 days

■Iodoquinol for 20 days

Side Effects & Complications

■As for amebiasis, giardiasis

■Contraindications to treatment: absolute: allergy to medications

■Contraindications to treatment: relative: asymptomatic patient, and

some feel no one should be treated

follow-up

Routine

■If treated, stools can be re-examined.

complications and prognosis

■Prognosis is good for symptoms, though organism may persist or

re-appear after an interval (? reinfection).

Blastomyces Dermatitidis..............................

RICHARD A. JACOBS, MD, PhD

history & physical

History

■In North America: southeastern, south-central states, especially bor-

dering Mississippi and Ohio River basins; Great Lakes region; St.

Lawrence River area of New York and Canada

■Middle-aged men with outdoor occupations that expose them to soil

may be at highest risk.

Signs & Symptoms

■Blastomycosis is a systemic disease with a wide variety of pulmonary

and extrapulmonary manifestations.