What is the primary treatment for disseminated Blastomycosis?

The primary treatment for disseminated Blastomycosis is Amphotericin B or Itraconazole. Disseminated Blastomycosis is a serious fungal infection caused by the organism Blastomyces dermatitidis, which can affect multiple organ systems. Amphotericin B, a polyene antifungal, is typically used for its potent activity against a wide range of fungi, making it suitable for severe cases or those that are life-threatening.

Itraconazole, a triazole antifungal, is also effective for less severe cases of Blastomycosis or in patients who are not critically ill. It is often used for chronic and less severe forms of the disease after initial treatment with Amphotericin B.

Fluconazole and Voriconazole are primarily effective against Candida and Aspergillus species, respectively, and are not the first line for treating Blastomycosis. Ketoconazole is an older antifungal, less preferred now due to its side effect profile and lower efficacy compared to other modern antifungals. Thus, the combination of Amphotericin B for immediate, severe treatment and Itraconazole for ongoing management makes the correct choice the most appropriate approach for disseminated Blastomycosis.