According to a case report in the Journal of Emergency Medicine, the construction worker rocked up to see a doctor with a really painful lesion under his bottom lip that had been slowly growing over the course of seven months.
The doctors described it as "a large, heme-crusted, verrucous, erythematous plaque with a rolled, indurated border on the lower vermillion and cutaneous lips," and that does not sound like something you want growing on you.
However, he wasn't presenting with any other symptoms - no headaches, chills, fever, malaise, weight loss, and his lab workup and chest radiograph showed nothing.
He had, he told the doctors at John H. Stroger Jr. Hospital of Cook County in Chicago, used a "woodworking blade" to cut off a pimple before the lesion started growing.
A skin biopsy revealed the answer: spores of a fungus called Blastomyces dermatitidis, which is responsible for a fungal infection called blastomycosis.
Blastomyces is usually found in the soil and wet, decaying wood around rivers and streams. People (and other animals, especially dogs) usually become infected when they breathe the spores - it presents as a lung infection in about 70 percent of patients.
According to the CDC, only about half the patients that are infected will show any symptoms at all, and they are usually flu-like - fever, cough, weight loss, night sweats, muscle and joint aches, and fatigue.
But, although it's rare, it is possible for the spores to enter the human body through a wound in the skin.
To date, the doctors said, only 50 cases of contracting blastomycosis in this manner - cutaneous blastomycosis - have ever been described in literature, and it usually occurs in morgue workers, or dog handlers bitten by an infected animal.