Fever, progressive nonproductive cough, and headache

Blastomyces dermatitidis is a dimorphic endemic fungus. Humans most commonly develop pulmonary disease, less frequently bone and skin disease. Pulmonary disease usually manifest radiographically as air-space consolidations or as a masslike lesion frequently with irregular margins or satellite lesions. Blastomycosis infection of the central nervous system involvement occurs rarely but may present as either a mass lesion or with imaging findings consistent with meningitis. Amphotericin B is the treatment of choice for life-threatening and central nervous system disease. Itraconazole can be used for infections that are not life-threatening.