Like blastomycosis in dogs, the disease in people can present as primary pulmonary disease or pulmonary disease with extrapulmonary sites of lesions (most commonly skin, bones and the genitourinary tract).

In humans, cases occur with a particularly marked geographic localization to areas near water/rivers. In Wisconsin, one survey found that 82% of patients lived or visited within 500m of a river. (Similarly, 95% of cases in one study of Wisconsin dogs were in animals that lived within 400m of water. However, given the propensity for outdoor dogs to wander through various environments, cases also occur in dogs without a direct connection to water. It appears that dogs are actually ~10-fold more sensitive to infection than people, possibly because they acquire a larger inoculum of organisms by "rooting" in the soil.)

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