• People have a fever, chills, and drenching sweats and sometimes chest pain, difficulty breathing, and a cough.
• The infection may spread to the skin, bones, reproductive and urinary tracts, and tissues covering the brain, causing swelling, pain, and other symptoms.
• A sample of infected sputum or tissues is removed and sent for culture, and a chest x-ray is taken.
• Antifungal drugs must be taken for months.

(See also Overview of Fungal Infections.)

Spores of Blastomyces enter the body through the airways when the spores are inhaled. Thus, blastomycosis affects primarily the lungs, but the fungi occasionally spread through the bloodstream to other areas of the body, most commonly the skin.

Blastomycosis may be more common among and more severe in some people with a weakened immune system. Unlike most fungal infections, blastomycosis is not more common among people with AIDS. However, it tends to be more severe in people with AIDS.

Most cases of blastomycosis occur in areas of North America where the fungus lives in the soil near river beds:

• The Ohio and Mississippi River valleys (extending into the middle Atlantic and southeastern states)
• The northern Midwest
• Upstate New York
• Areas of southern Canada that border the Great Lakes and Saint Lawrence River

Rarely, the infection occurs in the Middle East and Africa.