Spring Fever and Blastomycosis

When we lived up in Eagle River (a great town with great people) springtime meant freedom to get outside without worrying about the cold temperatures and snow. This of course, meant that your pets, too, could enjoy the fresh air and do their thing outside. We were heavy into boating and fishing and there was always a landscaping project going on.

Up north, all residents are keenly aware of a fungus that lives in the soil. It seemed that everyone you knew had a story of how their dog or their cousin came down with blastomycosis. I wondered how I never got it, as I was always digging in the dirt, raking leaves or blowing pinecones off the drive so the kids could ride their bikes or draw with chalk. I was sure that if a lab test was available that I would have had a measureable titer.

But as it was, our dog came down with symptoms…fever (104 degrees rectally), cough, lethargic, and no appetite at all. Blasto is usually inhaled and the lungs are infected first. It can also enter the body through abrasions in the skin. It always is a slow grower that tends to become systemic and life-threatening. The treatment of choice was an anti-fungal known as amphotericin, also known as ampho-terrible because if the blasto didn’t kill you, the amphotericin would by shutting down the liver. When the jaundice appears in the eyes of your beloved pet, things are really going downhill. It means that even 3 times /week IV drip at the vet isn’t enough. That’s the point where we were at, the moment of decision on how to mercifully let our dog go.

 Al wanted to try the human treatment sporonox since the other method was failing. At this point, I was feeding Bones whatever he would eat… waffles one day, a hamburger the next. He hardly ever ate the previous day’s food again the next day. But slowly, over 4 months, he recovered! People were very happy for us, and the vet was perturbed for a time to be overruled by a family doc, but all In all, it was a breakthrough.

In humans, it was a deep first morning sputum sample, right after showering, that we wanted people to get. No spit, just the terrible thick crap from deep in the lungs. Under the microscope, blasto has a distinctive, large single budding form. It often causes a pneumonia, which is usually treated with antibiotics, which has no effect on blasto, except for possibly confounding the diagnosis and delaying treatment. If the entry into the body is through a break in the skin, diagnosis can be even more problematic. It is so slow growing that it doesn’t produce symptoms for a long time, probably months.

So we became pretty proficient in getting a handle on this disease while were lived there. It is still a huge problem because it is part of the soil. Vacationers need to be aware of the endemic nature of microorganisms of areas they visit.

Sadly, after Bones recovered completely, we lost him one winter when it snowed so much that he actually just walked over the fence that surrounded our yard. A neighbor saw him walking on the frozen river. We knew he didn’t like to swim and we thought that he must have gone through the ice where it was thin. Still, Eagle River is home to the most hard-working, creative and fun-loving people we have ever met. It will always be on the top of our list for best places.