Blastomycosis is a fungal disease that is endemic in parts of North America.It is very rare in China and also commonly misdiagnosed,often as cancer or other infectious diseases.The clinical profile of a case of disseminated blastomycosis with pulmonary changes and skin ulcers was described.He had been misdiagnosed with tuberculosis,after adequate therapy with a lipid formulation of amphotericin B,followed by itraconazole,the lung and skin lesions improved.Then the five cases reported in China and literatures were reviewed.The aim of this report was to improve the knowledge regarding blastomycosis for physicians in China to avoid delaying adequate therapy.