Bariola et al listed criteria for the diagnosis of blastomycosis. These can help a physician describe the certainty of the diagnosis. The authors are from the University of Arkansas for Medical Sciences, the University of Alabama, Rush Medical College, Vanderbilt University, the University of Tennessee and Texas Tech University Health Sciences Center.
Definite blastomycosis - one or more of the following:
(1) positive culture for B. dermatitidis from any site
(2) histologic evidence of B. dermatitidis from any site
Probable blastomycosis - one or more of the following:
(1) presence of antibodies to B. dermatitidis AND clinical findings consistent with blastomycosis
(2) presence of B. dermatitidis antigen AND clinical findings consistent with blastomycosis
Blastomycosis involving the central nervous system (CNS)
Evidence for Blastomycosis
Clinical Features
Certainty of Diagnsois
positive culture from CNS for B. dermatitidis
NA
definite
histological evidence of B. dermatitidis in a biopsy from the CNS
NA
definite
positive culture from outside the CNS for B. dermatitis
abnormal CNS imaging findings or abnormal CSF with improvement after antifungal therapy
probable
histological evidence of B. dermatitidis in a biopsy from outside the CNS
abnormal CNS imaging findings or abnormal CSF with improvement after antifungal therapy
probable
positive culture from outside the CNS for B. dermatitis
abnormal CNS imaging findings or abnormal CSF
possible
histological evidence of B. dermatitidis in a biopsy from outside the CNS
abnormal CNS imaging findings or abnormal CSF
possible
where:
• These same criteria can be modified for diagnosis of blastomycosis affecting other organs.
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