Page 382 - 2021 IDMT Digital

HISTOPLASMOSIS
Introduction:
• Histoplasma capsulatum LV D IXQJXV WKDW KDV EHHQ LVRODWHG IURP VRLO FRQWDPLQDWHG ZLWK
ELUG RU EDW GURSSLQJV LQ HQGHPLF DUHDV
o &HQWUDO DQG HDVWHUQ 86 HDVWHUQ &DQDGD 0H[LFR &HQWUDO DQG 6RXWK $PHULFD
$IULFD DQG 6( $VLD
o ,QIHFWLRQ SUHVXPDEO\ WDNHV SODFH E\ LQKDODWLRQ RI FRQLGLD VSRUHV
• 7KH RUJDQLVP SUROLIHUDWHs DQG XQGHUJRHV O\PSKRKHPDWRJHQRXV VSUHDG WR RWKHU RUJDQV
Subjective:
• 6LJQV DQG 6\PSWRPV
o 0DODLVH IHYHU FKLOOV DQRUH[LD P\DOJLDV FRXJK SOHXULWLF FKHVW SDLQ
o &RXJK FDQ FRQWLQXH IRU PRQWKV
• )RFXVHG +LVWRU\
o 5HFHQW WUDYHO WR 0LGZHVW 86
o ([SRVXUH WR FDYHV RU ELUG GURSSLQJV
Objective:
• 3K\VLFDO ([DP
o ,QVSHFWLRQ PD\ VKRZ IHYHU ZHLJKW ORVV K\SRWHQVLRQ DQG VKRFN LI WKH SDWLHQW LV
LPPXQRFRPSURPLVHG
o $XVFXOWDWLRQ ZLOO VKRZ FRDUVH EUHDWK VRXQGV SOHXUDO IULFWLRQ UXE
o 3DOSDWLRQ PD\ UHYHDO KHSDWRPHJDO\ DQG/RU VSOHQRPHJDO\ LQ GLVVHPLQDWHG
LQIHFWLRQ
• 7RROV
o &;5 VKRZV KLODU RU PHGLDVWLQDO O\PSKDGHQRSDWK\ ZLWK RU ZLWKRXW SDWFK\
LQILOWUDWHV
Assessment:
• 'LIIHUHQWLDO
o $FXWH SXOPRQDU\ LQIHFWLRQ UHVSLUDWRU\ VLJQV RU V\PSWRPV
o &KURQLF SXOPRQDU\ LQIHFWLRQ KLVWRU\ RI VPRNLQJ OXQJ GLVHDVH RU FKURQLF
SXOPRQDU\ LQIHFWLRQV

Plan:
• 0HGLFDWLRQ
o ,WUDFRQD]ROH
• (YDFXDWH DOO FKURQLF DQG GLVVHPLQDWHG FDVHV IRU VSHFLDOW\ FDUH
Patient Education:
• 0RVW DFXWH SXOPRQDU\ LQIHFWLRQV UHVROYH VSRQWDQHRXVO\ LQ ZHHNV
• )ROORZ XS $FWLRQV
o 5HWXUQ LI QR LPSURYHPHQW ZLWKLQ KRXUV
Preceptor Directive:
• Blue Directive: Contact Preceptor Immediately

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