Case Report Pulmonary Blastomycosis Diagnosed in Hawai’i

Blastomycosis, a fungal infection caused by Blastomyces dermatitidis, was once thought to be endemic only to the Central and Great Lakes regions of the United States of America. We present the first reported case series of patients documenting the diagnosis of blastomycosis in the Pacific region. In both cases, exposure to endemic areas was retrospectively identified. ness of symptoms during clinical infection, and the normal self-limited course, diagnosis of infection is rare even in endemic areas. Clinical infections may be successfully treated with antifungal agents. Itraconazole can be used for moderate infections, but amphotericin B should be used for life-threatening disease and whenever central nervous system involvement occurs. We present a case series of patients who were diagnosed with pulmonary blastomycosis in Hawai’i. In both cases, we were able to retrospectively identify exposure to endemic areas of the United States.