Primary Cutaneous Blastomycosis: An Ulcerated Wound in an Immunocompetent Patient

The report describes a case of cutaneous blastomycosis. The patient was a healthy elderly male with a history of rectal adenocarcinoma, who presented with an ulcerating wound on his left buttock. Fungal culture was positive for Blastomyces dermatitidis, and the patient was treated with itraconazole followed by voriconazole for three months, which led to clinical resolution of the infection. This highlights an atypical case of blastomycosis, which presented as an isolated skin condition, without pulmonary or hematogenous complications. There are many challenges to diagnosing blastomycosis due to its wide range of symptoms, which can mimic other conditions, making it difficult to diagnose. Accurate diagnosis of blastomycosis is crucial to provide effective treatment and prevent potential complications, such as the infection spreading to other parts of the body and causing systemic symptoms. The report concludes by emphasizing the importance of a high index of suspicion for the diagnosis of cutaneous blastomycosis.