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Disseminated Blastomycosis with Cutaneous Lesions

Imaging findings

CT chest and neck in a young female show large, mass-like consolidations in the lower lobes, paraspinal/chest wall masses, and multiple nodular, pustular cutaneous lesions on the neck and chest wall. Skin biopsy grew Blastomyces dermatitidis.

Key takeaways

Blastomycosis is a dimorphic fungus endemic to the Great Lakes and Mississippi River valleys. Disseminated blastomycosis has a strong predilection for the skin (causing pustular or verrucous lesions) and bones. Cutaneous lesions can occasionally be visualized directly on CT scans.

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