Image Challenge – December 19th

Question: What infectious etiology is demonstrated by the cutaneous manifestations below?

Reference here Ladizinski, B. and Piette, W. (2018). Disseminated Cutaneous Blastomycosis. NEJM. 379:74. Accessed at

Answer: The answer is cutaneous blastomycosis, an endemic fungi. This pathogen can be found in regions surrounding the Great Lakes and St. Lawrence River and in Kenora, Ontario. It is also seen in Ohio and the Mississippi River valleys. It is thought to be transmitted from inhaling spores that reside in soil and decomposing organic matter, and can lead to pulmonary, cutaneous, CNS, genitourinary, lymphatic signs/symptoms.

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