Discover and read the best of Twitter Threads about #fungalfriday
Most recents (2)
1/
First of 2 tweets! #GalactoMagic
80F nursing home resident presents w/ 3 days of fever, cough, & SOB
Vitals: T 38.6C, HR 110, BP 120/80, O2 94% on 3L. Exam notable for left basilar rhonchi & crackles
CXR shows LLL opacity. She is started on ceftriaxone & doxy
First of 2 tweets! #GalactoMagic
80F nursing home resident presents w/ 3 days of fever, cough, & SOB
Vitals: T 38.6C, HR 110, BP 120/80, O2 94% on 3L. Exam notable for left basilar rhonchi & crackles
CXR shows LLL opacity. She is started on ceftriaxone & doxy
2/
2 days later, she is still having intermittent fevers with Tmax 38.1C, O2 94% on 3L, RR 30
A CT chest reveals a dense LLL consolidation
In addition to sputum cultures, which of the following tests should be ordered?
2 days later, she is still having intermittent fevers with Tmax 38.1C, O2 94% on 3L, RR 30
A CT chest reveals a dense LLL consolidation
In addition to sputum cultures, which of the following tests should be ordered?
1/12
Answer: Blood cultures
The patient is a nursing home resident w/ ongoing fevers, hypoxia, high RR, with a LLL consolidation
In addition to sputum cx, the patient should also have blood cx (fits pneumonia severity index IV)
There is no dysuria to prompt an UA
Answer: Blood cultures
The patient is a nursing home resident w/ ongoing fevers, hypoxia, high RR, with a LLL consolidation
In addition to sputum cx, the patient should also have blood cx (fits pneumonia severity index IV)
There is no dysuria to prompt an UA
1/
First of 2 tweets! #GalactoMagic
55F w/ COPD has 3 days of fevers, SOB & cough. T 38.2C, HR 112, BP 100/75, RR 22, O2 93% on 100% non-rebreather. Exam- crackles b/l
CT chest- ground-glass opacities b/l
Rapid flu swab + for influenza A, sputum & blood cultures negative
First of 2 tweets! #GalactoMagic
55F w/ COPD has 3 days of fevers, SOB & cough. T 38.2C, HR 112, BP 100/75, RR 22, O2 93% on 100% non-rebreather. Exam- crackles b/l
CT chest- ground-glass opacities b/l
Rapid flu swab + for influenza A, sputum & blood cultures negative
2/
W/ oseltamivir, ceftriaxone & azithro, she defervesces. 3 wks later, has fevers & worsening SOB. Repeat CT chest- new 2cm RUL cavitary lesion. Resp viral panel +influenza A, blood & sputum cultures neg. Which of the following is the most likely cause of the cavitary lesion?
W/ oseltamivir, ceftriaxone & azithro, she defervesces. 3 wks later, has fevers & worsening SOB. Repeat CT chest- new 2cm RUL cavitary lesion. Resp viral panel +influenza A, blood & sputum cultures neg. Which of the following is the most likely cause of the cavitary lesion?
1/11
Answer: Pulmonary aspergillosis. Patient has several RF for pulm aspergillosis including COPD, critical illness, and severe influenza infection. As a refresher, here is a table with RF for aspergillosis
Answer: Pulmonary aspergillosis. Patient has several RF for pulm aspergillosis including COPD, critical illness, and severe influenza infection. As a refresher, here is a table with RF for aspergillosis
