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Hans Lipper, a 44yom, was admitted this morning with a fever, chills, and substernal pain; histoplasmosis...

Hans Lipper, a 44yom, was admitted this morning with a fever, chills, and substernal pain; histoplasmosis is suspected on the basis of exposure to appropriate condtions. Patient is alert and oriented. Has peripheral IV.

HR 106, BP 138,/60, temp. 38.4C RR 24 slightly labored. BS decreased, bases with crackles on inspiraton, occasional cough often productive. Chest x-ray diffuse patchy parenchymal densities.

pH 7.48 pCO2 32 PaO2 60 Sat 93 HC03 24 on RA

Hgb 13.8 WBC 12, 600

The attending physician ask you for respiratory treatment recommendations. What would you suggest be ordered at this time and why?

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Answer #1

The patient diagnosed with histoplasmosis, which is also known as cave disease.

Histoplasmosis is an airborne fungal infection of lungs caused by Histoplasma capsulatum. Symptoms of histoplasmosis range from mild respiratory infection to severe pneumonia.

Treatment includes

- Start treatment with antifungal medication ( amphotericin and itraconazole)

- Administer antipyretics for elevated temperature (Acetaminophen)

- Administer steroids to reduce inflammation (Prednisone)

- Give oxygen therapy

- Administer diuretics if necessary to reduce crackles (Pulmonary edema)

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