Blastomycosis of the scrotum: Not a fun guy.

Blastomycosis dermatitidis is a fungal pathogen endemic to North America. Infection from inhalation of its conidia has diffuse clinical manifestations. These can include genitourinary system infections which may manifest as ulcerative, draining skin lesions. Tissue culture is essential as anerobic bacteria and fungi grow more reliably through this medium, than with tissue swabs. A more accurate and efficient diagnosis of blastomycosis, as evidenced in this case, would have prevented prolonged treatment for presumed bacterial epididymo-orchitis and would have eliminated concern regarding possible disseminated malignancy.