Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, non-productive cough, and low-grade fever. History significant for recent solid organ transplant/hematopoietic stem cell transplant or profound immunosuppression. Symptoms duration: [Number] days. Denies chest pain or hemoptysis. Current immunosuppressive regimen: [Medication list].
Clinical Examination Findings
Vitals: Tachypnea (RR >20), hypoxemia on room air (SpO2 <92%). Pulmonary exam: Bilateral fine end-inspiratory crackles, no wheezing or consolidation. Cardiovascular: Tachycardia, regular rhythm, no murmurs. Skin: No rashes or petechiae. General: Appears ill, accessory muscle use noted.
Treatment Protocol
Initiate intravenous Ganciclovir [Dose] mg/kg every 12 hours or Valganciclovir [Dose] mg orally daily. Monitor CBC and renal function closely. Consider reduction of immunosuppressive therapy. Supportive care: Supplemental oxygen to maintain SpO2 >92%, fluid management, and prophylaxis for PJP if indicated.