DIAGNOSIS
■ CXR: Fibronodular, interstitial, or alveolar infiltrates
■ Positive fungal stains, cultures, or serologic testing are confirmative.
TREATMENT
■ Pulmonary blastomycosis
■ Life-threatening: Amphotericin B
■ Mild to moderate: Itraconazole, ketaconazole, fluconazole
■ Many cases resolve spontaneously. Observation is a valid option in the
immunocompetent patient.
■ Disseminated blastomycosis
■ CNS or life threatening: Amphotericin B
■ Mild to moderate: Itraconazole
■ Immunocompromised and pregnant patients: Amphotericin B
COMPLICATIONS
Dissemination to skin, bones, joints, prostate
Psittacosis (Parrot Fever)
CAUSES
Caused by organism Chlamydia psittaci,which is transmitted from birdsto
humans
SYMPTOMS/EXAM
■ History of occupational or recreational exposure to birds
■ Subacute illness with protracted symptoms
■ Headache and relative bradycardia
TREATMENT
■ Tetracyclines, eg, doxycycline and tetracycline
■ Erythromycin as second-line agent
■ Chloramphenicol and rifampin have also been used effectively.
COMPLICATIONS
Renal failure, encephalitis, endocarditis, DIC
Q Fever
CAUSES
Caused by the organism Coxiella burnetii,which is transmitted to humans
fromsheep, goats, and cattle
SYMPTOMS/EXAM
■ History of occupational or recreational exposure to sheeps, goats, or cattle
■ Flulike illness along with dry cough and pleuritic chest pain
■ Confusion and GI symptoms are common.
DIAGNOSIS
■ Diagnosed by serologic testing
TREATMENT
Doxycycline
THORACIC AND RESPIRATORY
DISORDERS