Case Study 2 A 52-year-old man presents to the physician's office for the evaluation of a cough and fever. He has these

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Case Study 2 A 52 Year Old Man Presents To The Physician S Office For The Evaluation Of A Cough And Fever He Has These 1 (113.63 KiB) Viewed 12 times

Case Study 2 A 52-year-old man presents to the physician's office for the evaluation of a cough and fever. He has these symptoms for approximately one week. He has also noted a sharp chest pain that is worse when he takes a deep breath. He has some associated fatigue, headaches, achy joints, and sweatiness at night. He has been using an over-the-counter flu medication, which helps to reduce the cough, but he wanted to be checked because his symptoms are lingering. He has no history of pulmonary disease and he has never smoked cigarettes. He has had no exposure to ill contacts. His only recent travel was a weeklong golf vacation to Phoenix, which he took 3 weeks ago. On examination, he is comfortable appearing and in no respiratory distress. Hi temperature is 37.7° C (99,9° F), and his vital signs are otherwise normal. His pulmonary examination is notable for some faint expiratory wheezing and crackles in his left upper lung. The remainder of his physical examination is unremarkable. A chest x-ray shows a hilar adenopathy. A CBC shows a normal total white blood count and high percentage of circulating eosinophils. Microscopic examination of a fresh sputum sample treated with KOH reveals numerous spherules. Questions 1. What organism is likely for the patient's symptoms? (Please see image above) 2. For this organism, how do spherules form and what is their role in propagating infection? 3. Given the image above, what areas of the United States is this fungus endemic? 4. How is infection with his organism transmitted? 5. Once infected with, or exposed to this organism, how long does it take before symptoms appear? 6. If infection with this organism is disseminated, which areas of the body are affected by dissemination? 7. Who is likely to develop disseminated infection with this organism? 8. Describe the process of how is the definitive diagnosis of this infection made. 9. For patients with complicated disease of this organism, how is the infection treated?