Fungal Infections Who is at Risk Seriously ill patients being treated with Corticosteroids Antineoplastic drugs Immunosuppressive drugs Patients with AIDS Patients with Cystic Fibrosis

Fungal Infections Histoplasmosis Coccidiodomycosis Blastomycosis Cryptococcosis Aspergillosis Pneumocystis pneumonia Nocardiosis Actinomycosis Candidiasis

Diagnosis Skin testing Serology Biopsy

Drug therapy Amphotericin B Intravenous Side 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 function Ensure adequate hydration

Drug Therapy Oral 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 Abscess Causes Aspiration of material from GI tract into lungs Lung cancer Tuberculosis

Risk Factors for Aspiration AlcoholismSeizureDisorder StrokeGeneralAnesthesia Drug Overdose

Signs and Symptoms Productive cough of purulent foul smelling and foul tasting sputum Fever and chills Pleuritic pain Dyspnea Weight loss

Diagnosis Sputum cultures – obtained first so can confirm treatment modalities Chest x-ray Bronchoscopy

Treatment and Nursing Care Drug Therapy Antibiotics Penicillin Clindamycin Antipyretics Chest physiotherapy and postural drainage Increase fluid intake Rest Good nutrition

Complications Lobectomy Pneumonectomy