Page 383 - 2021 IDMT Digital
P. 383
COCCIDIOIDOMYCOSIS
Introduction:
• Coccidioidomycosis VKRXOG EH FRQVLGHUHG LQ WKH GLDJQRVLV RI DQ\ REVFXUH LOOQHVV LQ D
SDWLHQW ZKR KDV OLYHG LQ RU YLVLWHG DQ HQGHPLF DUHD
• &DXVHG E\ PROGV WKDW JURZ LQ VRLO LQ FHUWDLQ DULG UHJLRQV RI WKH VRXWKZHVWHUQ 86 LQ
0H[LFR DQG LQ &HQWUDO DQG 6RXWK $PHULFD
Subjective:
• 6LJQV DQG 6\PSWRPV
o ,QIOXHQ]D OLNH LOOQHVV ZLWK PDODLVH IHYHU EDFNDFKH KHDGDFKH DQG GU\ FRXJK
o $UWKUDOJLD DFFRPSDQLHG E\ SHULDUWLFXODU VZHOOLQJ RIWHQ RI WKH NQHHV DQG DQNOHV
LV FRPPRQ
o (U\WKHPD QRGRVXP PD\ DSSHDU GD\V DIWHU RQVHW RI V\PSWRPV
• )RFXVHG +LVWRU\
o 7UDYHO +LVWRU\
Objective:
• 3K\VLFDO ([DP
o )HYHU DQG WDFK\SQHD
o 9DULRXV UDVKHV GLIIXVH IDLQW HU\WKHPDWRXV UDVK ODVWLQJ OHVV WKDQ RQH ZHHN
(U\WKHPD PXOWLIRUPH
(U\WKHPD QRGRVXP SDLQIXO UHG QRGXOHV XVXDOO\ RFFXUULQJ RQ WKH VKLQV
o 'LIIXVH DXVFXODWRU\ ILQGLQJV RQ OXQJ H[DP
o 3DWLHQWV ZLWK PHQLQJLWLV PD\ KDYH SDSLOOHGHPD RQ IXQGRVFRS\ RU QHXURORJLF
PDQLIHVWDWLRQV
Assessment:
• 'LIIHUHQWLDO
o ,QIOXHQ]D 85, W\SH V\PSWRPV, myalgias
o 3QHXPRQLD DGYHQWLWLRXV OXQJ VRXQGV
o +LVWRSODVPRVLV KHSDWRVSOHQRPHJDO\
Plan:
• 0HGLFDWLRQV iWUDFRQD]ROH IRU severe FDVHV
• *HQHUDO V\PSWRPDWLF WKHUDS\ LV JLYHQ DV QHHGHG IRU GLVHDVH OLPLWHG WR WKH FKHVW ZLWK QR
HYLGHQFH RI SURJUHVVLRQ
• (YDFXDWH VHYHUH FDVHV DQG UHIHU DOO SDWLHQWV WR D VSHFLDOLVW IRU FDUH DQG HYDOXDWLRQ
Patient Education:
• $FXWH SXOPRQDU\ GLVHDVH ZLOO OLNHO\ UHVROYH XQWUHDWHG LQ ZHHNV
• 0HQLQJHDO GLVHDVH UHTXLUHV OLIHORQJ WKHUDS\
• )ROORZ XS $FWLRQV UHWXUQ IUHTXHQWO\ IRU UH-HYDOXDWLRQ RI LPSURYHPHQW
Preceptor Directive:
• Blue Directive: Contact Preceptor Immediately
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