Pappas reviewed reports of blastomycosis in people with HIV in a retrospective survey, identifying only 15 cases. 12/15 had a previous or concomitant AIDS-defining illness; only one had a CD4 count above 200. Two patterns of disease emerged: localised pulmonary involvement (n=7) and disseminated or extrapulmonary blastomycosis (n=8). CNS involvement was common (40%). Among the 9 patients who survived longer than one month, all received amphotericin B as initial therapy and most received subsequent therapy with ketoconazole.