Blastomycosis and Tuberculosis in Early American Indians: a Biocultural View

Abstract

Of all the skeletal disorders known to resemble tuberculosis, blastomycosis poses the greatest diagnostic challenge to the paleopathologist. While these two diseases produce similar lesions in the vertebral bodies, their overall skeletal patterns are quite distinctive. This study considers a wide array of biocultural and epidemiologi ca! variables to interpret the patterned skeletal lesions observed in individuals from two prehistoric archaeological sites, Mobridge and Averbuch. A combined total of 59 individuals from both sites exhibit a constellation of inflammatory lesions with the spine, ribs, and long bone shafts favored. Adults are principally affected with a 2 to 1 preference for males. The physical and cultural environmental settings for these sites are examined and found to contain elements conducive to blastomycotic, tuberculous, and nontuberculous mycobacterial infec tion. A differential diagnosis based on lesion appearance, location, age, sex, and the natural history of each of these diseases suggests that blastomycosis and mycobac terial infection were endemic to these populations, with the former disease pre dominating.

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