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Blastomycosis. Presented by Dr. Theodore Cornbleet, Dr. Sidney Barsky, and (by invitation) Dr. Harold Marks.
History.—This 20-year-old Negro gives a history of cough for two months and three facial granulomas for 21 days. He first developed a nonproductive cough with left pleural pain two months prior to admission to hospital. There was no hemoptysis. Three weeks before admission he noticed on his neck a small lesion which grew rapidly. Two additional similar growths appeared on the face.
The past history and the family history were noncontributory.
Physical Examination.—There were three almond-sized, granulomatous, crust-covered lesions, one each on the neck, the chin, and the forehead. These lesions had sloping borders containing minute vesicles. Palpable nontender cervical nodes were present. There was left chest dullness and some rales in the right base. Blood pressure was 128/70, pulse 100, respiration 26.
Laboratory Findings.—Blood culture showed no growth. Sputum culture showed