REGIONAL – Crystal Linaman feared she had cancer. With chest pains so severe she could barely get off the couch, the Tower woman went to a doctor. A CAT scan detected a large mass in her lung, furthering her fear that she might have a deadly tumor.

A biopsy later ruled out cancer and changed the diagnosis to blastomycosis, a fungal infection with symptoms that mimic a host of other ailments from pneumonia to arthritis.

The disease is caused by a fungus, blastomyces dermatidis, which exists as a mold in the environment and as a pathogenic yeast form in the body. It has killed hundreds of dogs in St. Louis County, where the mold is particularly abundant, but it also infects humans, and such infections, though rare, can be deadly.

In Minnesota, health officials have recorded 443 human blastomycosis cases from 1999-2012, according to the Minnesota Department of Health. Of those, 105, or nearly a quarter, were diagnosed in residents of St. Louis County, even though the county makes up only 3.6 percent of the state’s population. And the MDH believes that more than 28 percent of individuals statewide who have been diagnosed with the disease were originally infected in St. Louis County.

St. Louis County Public Health Nursing Supervisor Kelly Lind said the county’s terrain accounts for the difference. The fungus is more common in moist soils or soils enriched with organic debris. The abundant waterways, forestlands and swamps provide an ideal breeding ground for the fungus, according to Lind.

“Blastomycosis is still pretty rare, even in St. Louis County,” said Lind. “It’s a naturally occurring fungus in the environment. There’s no way to eradicate it or prevent its growth. But people need to be aware of the possibility of blastomycosis if they start exhibiting symptoms.”

Recognizing those symptoms, however, can be difficult because the symptoms often resemble those of other diseases such as the flu, pneumonia or lung cancer. But antibiotics or other treatment regimes that typically address those symptoms have no effect in combating blastomycocis. If symptoms, which may include joint pain, fever, chills, headaches, a persistent cough, chest pains, night sweats and weight loss, continue, you should be tested for blastomycosis.

Animals affected

Blastomycosis also affects a broad range of animal hosts. Dogs, in particular, are highly vulnerable, initially exhibiting acute respiratory symptoms, which rapidly progress to death. Cats are also frequent victims. Linaman said her dog died about the same time she took ill and the family’s cat also appears to be infected.

Dr. John Fisher, of the Lake Vermilion Veterinary Clinic, said he has treated numerous dogs for blastomycosis. The sooner a dog is diagnosed with the disease, the greater the chance of a full recovery, he said. “Early and vigorous treatment can restore a dog’s health.”

Blastomycosis can sometimes be difficult to diagnose, Fisher said, because it is so chameleon-like in its symptoms. “But because of our history and the terrain here, it’s something you always have to keep in the back of your mind,” he said.

When Fisher suspects blastomycosis, the disease can be confirmed with a highly accurate urine test.

Treatment for the disease involves an oral anti-fungal medication, said Fisher. “Costwise, it can be very expensive, in excess of $1,000 with the dog being medicated for six weeks or longer.”

Fisher said one concern he has is people whose animals may contract blastomycosis while visiting the area in the summer. The fungal disease may not exhibit any symptoms for 21 to 100 days.

“Some of these people are returning to states that have never encountered blastomycosis and don’t know to look for it,” he said. “If their dogs get sick and don’t respond to normal treatment, they need to demand a test for blastomycosis.”

Statistics

People also need to be aware of the potential of blastomycosis, which can be deadly, if they become ill. A small outbreak of blastomycosis occurred in Mountain Iron when soil disturbed for a basement released fungal spores that affected both people and dogs in that community.

There was also a significant increase in blastomycosis cases among people in Minnesota recently. In 2013, there were 34 reported cases of blastomycosis in Minnesota — a 35-percent increase from the 22 cases reported in 2012.

The median age of the 2013 cases was 43 years old, and 26 cases, or 76 percent, involved males.

Twenty-five (76 percent) were hospitalized for a median of 11 days and two (6 percent) died as a result of their blastomycosis infections.

Blastomycosis manifests as a primary lung infection in about 70 percent of all cases, as it did in Linaman’s illness. Her family suspects that fungus had grown in the dirt in the crawlspace beneath their house.

“The dog wasn’t roaming around and I was a stay-at-home mom, so it’s likely that is where we inhaled the spores,” she said.

Linaman is being treated with the anti-fungal drug intraconazole and will be on the medication for at least six months. But she’s grateful that doctors were able to properly diagnose her illness and relieved that she’s not suffering from lung cancer.

Meanwhile, she’s concerned that her 18-month-old son Orion may also be infected with blastomycosis. He has a swollen lymph node and she’s already scheduled an appointment for biopsy for him.

Lind said education is key to battling blastomycosis. If people exhibit any of the symptoms, she urges them to seek medical attention immediately. The sooner they act, the better their chances for recovery will be.