CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
This article is part of the Research TopicComplex Interplay Between Lung Diseases and Multisystem Disorders: Pathogenesis, management, and OutcomeView all 22 articles
Cutaneous Clues to a Fungal Culprit: Disseminated Blastomycosis Presenting as Monoarthritis: A Case Report
Provisionally accepted
Paddy Ssentongo, MD, PhD*
Sarah Akhtar
Zinaida PerciuleacCourtland KayeRekha Aley CherianElizabeth Garrett
Shirley Albano-AluquinThomas N HelmLeslie J Parent- The Pennsylvania State University (PSU), University Park, United States
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Blastomycosis is a dimorphic fungal infection caused by Blastomyces dermatitidis and related species, classically presenting with pulmonary and cutaneous involvement. Musculoskeletal manifestations, particularly monoarthritis, are rare and diagnostically challenging. We present the case of a previously healthy 41-year-old man who developed nodular skin lesions, cough, pulmonary nodules and persistent left knee arthritis, initially thought to be due to pseudogout. The diagnosis of disseminated fungal infection was suggested by CT scan, skin biopsy, and confirmatory fungal culture that grew Blastomyces dermatitidis. This case highlights the atypical pattern of joint involvement, the need to expand the differentials as dictated by clinical signs, the role of multidisciplinary collaboration, and the diagnostic utility of skin biopsy and fungal culture.
Keywords: Blastomyces dermatitidis, Cutaneous fungal infection, Dimorphic fungi, disseminated blastomycosis, fungal septic arthritis, Inflammatory monoarthritis, pulmonary nodules
Received: 13 Sep 2025; Accepted: 12 Jan 2026.
Copyright: © 2026 Ssentongo, MD, PhD, Akhtar, Perciuleac, Kaye, Cherian, Garrett, Albano-Aluquin, Helm and Parent. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Paddy Ssentongo, MD, PhD
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