Blastomycosis physical examination

The physical manifestations of the disease depends on the organ of involvement. In the order of incidence the most commonly involved organs are lungs, skin, bones, genitourinary system, central nervous system and other organs.

• Fever ^[1]
• Tachypnea

• Oral ulcers can be seen in some patients

• In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.

• No masses

• Regular rate and rhythm
• Normal S1, S2
• No murmurs, rubs, or gallops

Findings consistent with parenchymal consolidation such as^[2]

• Dullness to percussion
• Increased fremitus
• Signs of pleura involvement such as pleuritic rub.

• Abdomen soft and non-distended with no scars or striations
• No pulsatile masses or abdominal bruits ascultated
• Spleen not palpable, liver not palpable

• Ulcerative lesions that bleed easily
• Verrucous lesions with irregular border and variegated appearance

• Soft tissue swelling around the area of involvement and discharging sinuses might be consistent with osteomyelitis.
• Arthritis can cause reproducible pain in joints.

• Pyuria
• Painful urination

• Ulcers that bleed on touch

Normal examination finding unless the infection is disseminated to brain resulting in meningitis,then findings include :

• Altered level of consciousness
• Nuchal rigidity

• 
  Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). ^[3]
• 
  Morphologic changes that took place upon a patient’s arm, which included keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). ^[3]
• 
  Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, which was caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). ^[3]
• 
  Patient’s right knee revealed the keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). ^[3]
• 
  Patient’s right ankle displayed keloidal scarring brought on due to a case of cutaneous blastomycosis, caused by Blastomyces dermatitidis. From Public Health Image Library (PHIL). ^[3]

Template:WS