A literature review concerning blastomycosis has been conducted. The involvement of the head and neck area appears to be very unusual, on the basis of autoptic observations. The most common diagnostic and subsequent therapeutic mistakes are pointed out. A new case is described and its clinical appearance, symptoms, diagnostic work up and therapeutic approach are discussed. This case report is of interest for three reasons: the rarity of this disease in our country, the possibility of confusing a Blastomyces infection with a cryptococcal one [correction of criptococcosy] and finally the therapeutic response to a new drug, not yet commercialized in Italy.

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