Fungal InfectionsWho is at RiskSeriously ill patients being treated with

CorticosteroidsAntineoplastic drugsImmunosuppressive drugs

Patients with AIDSPatients with Cystic Fibrosis

Fungal InfectionsHistoplasmosisCoccidiodomycosisBlastomycosisCryptococcosisAspergillosis

Pneumocystis pneumonia

NocardiosisActinomycosisCandidiasis

DiagnosisSkin testing

Serology

Biopsy

Drug therapyAmphotericin B

IntravenousSide effects

Hypersensitivity reactions Fever and chills Malaise Nausea and vomiting Thrombophlebitis at injection site

Pre-medicate with Benadryl to increase tolerance and decrease hypersensitivity

Monitor renal functionEnsure adequate hydration

Drug TherapyOral antifungal agents

ketoconazole (Nizoral)fluconazole (Diflucan)itraconazole (Sporanox)Flucytosine (Ancobon)

Monitor effectiveness with serology testing

Lung Abscess Pus-containing lesion of the lung

Formed by necrosis of lung tissue

Lung AbscessCauses

Aspiration of material from GI tract into lungs

Lung cancerTuberculosis

Risk Factors for Aspiration

Signs and SymptomsProductive cough of purulent foul smelling and foul tasting sputum

Fever and chillsPleuritic painDyspneaWeight loss

Diagnosis

Sputum cultures – obtained first so can confirm

treatment modalities

Chest x-ray

Bronchoscopy

Treatment and Nursing CareDrug TherapyAntibiotics

PenicillinClindamycin

Antipyretics Chest physiotherapy and postural drainageIncrease fluid intakeRestGood nutrition

ComplicationsLobectomy

Pneumonectomy