Blastomyces dermatitidis in India: first report of its isolation from clinical material

The isolation of Blastomyces dermatitidis in India is reported from the bronchial aspirate of a female asthmatic patient who had never travelled abroad. The patient was a resident of Rodhain, a small town in the District of Badaun (Uttar Pradesh), situated about 250 km south-east of Delhi. Apart from its demonstration by culture and direct microscopy of a bronchial aspirate, B. dermatitidis was seen microscopically on two occasions in KOH wet mounts and smears of sputum stained with periodic acid-Schiff's reagent. Anti-B. dermatitidis serum precipitins were shown by immunodiffusion in 3 of 4 serum samples from the patient. The identity of the fungus was based on its characteristic morphology in clinical specimens and in culture, conversion of the mold form to the yeast from in vitro and vice versa, and by verification of its pathogenicity in white mice. A detailed clinical and laboratory evaluation of the patient indicated that she had suffered from an episode of self-limited acute pulmonary blastomycosis that required no antifungal therapy. This is believed to be the first authentic report of the isolation of B. dermatitidis from clinical material in India.