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July 6, 1929


Author Affiliations

Atlanta, Ga.

JAMA. 1929;93(1):32. doi:10.1001/jama.1929.27110010004008d

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The case reported here is of interest on account of the rapidity with which blastomycosis progressed by the direct route along bones from the index finger to the upper arm, and by metastasis to the right lung, then to the left lung and finally to the left kidney.

The history dates back to Dec. 24, 1927, when the patient was pricked by a thorn on the left index finger while hunting rabbits. Papules appeared on all the fingers shortly afterward.

Jan. 12, 1928, a red spot was noticed on the index finger which developed into an abscess. The finger was lanced, January 18, 22 and 25, without relief.

The patient, a married man, aged 37, weighing 200 pounds (91 Kg.), came to me, Jan. 31, 1928. Physical examination was negative except for the infected finger, which was swollen to twice its size and of purplish glistening color. The blood and

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