0071643192.pdf

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