The drained pustule that had been treated with 10% potassium hydroxide revealed round, broad-based, budding yeasts, as did hematoxylin-eosin staining. Cultures of the tissue specimens confirmed the diagnosis of blastomycosis 2 weeks later. Oral itraconazole therapy was initiated; however, the patient continued to have temperature spikes and an elevated white blood cell count. Amphotericin B therapy was then initiated, and the patient showed a dramatic response, with improvement seen on his chest x-ray film, a decreasing white blood cell count, defervescence, clearance of his pustules after 2 days of therapy, and complete resolution on day 5 of treatment.
Pustular Eruption. Arch Dermatol. 2002;138(10):1371-1376. doi:10.1001/archderm.138.10.1371