The Curbsiders Internal Medicine Podcast #495 Fungal Infections -Histo/Blasto/Cocci with Dr. Andrej Spec
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Aug 18, 2025 Dr. Andrej Spec, an infectious disease expert and co-director of the Invasive Mycoses Clinic at Washington University, dives into the intricacies of fungal infections. He discusses how mislabeling mycoses can lead to diagnostic confusion and the impact of climate change on fungal disease spread. Through real-life cases, he highlights the importance of patient history in diagnosis and urges clinicians to proactively test for conditions like histoplasmosis and blastomycosis. Listeners will also learn about updated treatment approaches that can make all the difference.
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Histoplasma Antigen Cross-Reacts With Blasto
- Histoplasma antigen cross-reacts with blastomyces in about 90% of cases at higher loads.
- A positive histo antigen can act as a useful two-for-one screen for blastomyces antigens.
Warn Labs About Suspected Fungi
- Notify the laboratory when you suspect dimorphic fungi because cultures are biohazardous.
- Labs need appropriate handling to protect staff from occupational infections.
Blastomyces Mistaken For Metastatic Cancer
- Andrej Spec described a patient put on hospice for presumed metastatic cancer who actually had blastomycosis of bone.
- After rebiopsy the diagnosis changed and chemotherapy was stopped.
