Changing Patterns of Disease Severity in Blastomyces dermatitidis Infection, Quebec, Canada

Area of Science:

• Infectious Diseases
• Mycology
• Public Health

Background:

• Blastomycosis is a serious fungal infection endemic to North America.
• Temporal trends in blastomycosis severity and mortality are not well-documented in Quebec.

Purpose of the Study:

• To assess changes in blastomycosis severity and mortality rates in Quebec between 1988 and 2016.
• To identify independent risk factors associated with death in blastomycosis patients.

Main Methods:

• Retrospective multicenter cohort study.
• Inclusion of 185 blastomycosis patients diagnosed between 1988 and 2016.
• Analysis of demographic, clinical, and outcome data, including 90-day all-cause mortality.

Main Results:

• A significant increase in severe blastomycosis cases was observed over the study period.
• Independent risk factors for death included advanced age, immunosuppression, and >2 lung lobes involvement.
• No association was found between Blastomyces genotype and all-cause mortality.

Conclusions:

• The proportion of severe blastomycosis cases has risen in Quebec.
• Increasing numbers of immunocompromised patients contribute to the observed rise in severe disease.
• Age, immunosuppression, and disease extent are critical factors influencing blastomycosis mortality.