Blastomycosis in the Capital District of New York State: A Newly Identified Emerging Endemic Area.

Abstract Background The Centers for Disease Control and Prevention (CDC) and New York State Department of Health (NYSDOH) recently identified the Capital District of New York (CDNY) as an emerging endemic area for blastomycosis. However, no clinical or epidemiological description of blastomycosis in the CDNY has been published. Methods We performed a retrospective analysis of blastomycosis cases at Albany Medical Center (AMC) and Albany Stratton Veterans Affairs Medical Center (VAMC) from January 1, 2000 through June 1, 2019. Patients were identified via an institution-approved informatics system at the hospital's microbiology laboratory. Results We identified 20 patients diagnosed with blastomycosis over the past two decades. There was a nearly 9-fold increase in the annual number of cases in 2016–2019 compared to 2000–2015. The majority of the cases resided in the CDNY (90%) and 65% lived within the Mohawk River Valley. Most cases (85%) were assumed to be malignancies or non-mycotic infections prior to diagnosis, with median time between presentation and diagnosis of 53 days. Conclusion Our data support recent reports that blastomycosis is an emerging disease in the CDNY. Most cases were misdiagnosed as malignancy or non-mycotic infection leading to treatment delays.