2. Infection with a fungus called Blastomyces dermatitidis.
It usually presents a flu-like illness with fever, chills, productive cough, myalgia, arthralgia, and pleuritic chest pain.
Some patients fail to recover and develop chronic pulmonary infection or widespread disseminated infection; affecting the skin, bones, and genitourinary tract. It occasionally affects the meninges which cover the brain and spinal cord.
People who are at an elevated risk for the disease are those in areas with endemic disease with exposures to wooded sites; such as, farmers, forestry workers, hunters, and campers. The disease can leave permanent lung damage.