Internal Medicine

0521779407-C04 CUNY1086/Karliner 0 521 77940 7 June 14, 2007 20:37

Cystic Fibrosis Cysticercosis 455

■Nutritional support: diabetes and pancreatic insufficiency

➣Adequate caloric intake (may need calorie count)

➣Avoid fat restriction, ie, give adequate pancreatic enzymes

➣Diabetes: frequent blood glucose and sliding scale

Side Effects and Complications

■Antibiotics:

➣Side effects: rash, diarrhea, renal dysfunction (check levels of

aminoglycoside for safety)

follow-up

■Continue antibiotic therapy until back to baseline (usually 2–3 wk)

■Repeat spirometry at end of treatment

complications and prognosis

Complications

■Hemoptysis: if life-threatening or no response to antibiotics, con-

sider bronchial artery embolization

■Failure to respond to antibiotics: consider drug resistance, unusual

organisms (eg, fungus, mycobacteria)

■Ventilatory failure: consider nasal mask ventilation; full mechanical

ventilation used with reluctance because of difficulty weaning

Prognosis

■Median survival 31 y

■Consider lung transplantation for advanced disease

Cysticercosis........................................

J. GORDON FRIERSON, MD

history & physical

History

■Exposure: ingestingTaenia soliumeggs in contaminated food or

water or from dirty hands. Life cycle:Taenia solium(pork tapeworm)

acquired by man from eating undercooked pork containing encysted

larvae (cysticercoids). After maturing, segments of the tapeworm

are passed in stool, the eggs of which are infectious for man and pig.

Upon ingestion, larvae from the eggs are absorbed and pass to brain,

muscle, and SQ tissue, where they encyst.