Chao D, Steier KJ, Gomila R. Update and review of blastomycosis. J Am Osteopath Assoc 1997;97(9):525. doi: https://doi.org/10.7556/jaoa.1922.214.171.1245.
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Blastomycosis has a wide spectrum of clinical presentations. When a patient presents with chronic pneumonia, especially coexisting with cutaneous lesions, blastomycosis infection needs to be considered in the differential diagnosis. Erythema nodosum can rarely be associated with pulmonary blastomycosis. A positive culture is the gold standard of diagnosis; occasionally, the organism can be identified by its typical "shoe print" morphology with periodic acid-Schiff (PAS) stain. The Gen-Probe technique may be required to confirm the uncertain culture results. The preferred treatment for blastomycosis in less severe cases is oral itraconazole, with amphotericin B in disseminated cases.
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