Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [duration] history of [fever/cough/hemoptysis/pleuritic chest pain]. Significant for underlying immunocompromised state: [neutropenia/post-transplant/prolonged corticosteroid use]. Symptoms are progressive, characterized by [productive/non-productive] cough and [dyspnea/hypoxia]. No prior response to broad-spectrum antibiotics.
Clinical Examination Findings
General: Patient appears [ill/toxic/distressed]. Vitals: [Tachycardic/Febrile/Tachypneic]. Pulmonary: Auscultation reveals [crackles/rhonchi/diminished breath sounds] localized to [affected lobe]. Skin: [Presence/Absence] of cutaneous lesions or nodules. HEENT: [Presence/Absence] of sinus tenderness or mucosal ulcerations.
Treatment Protocol
Initiate antifungal therapy with Voriconazole [loading dose/maintenance dose]. Consider Isavuconazole or Liposomal Amphotericin B in cases of intolerance or resistance. Monitor therapeutic drug levels (TDM) and liver function tests. Surgical consultation for potential resection of localized lesions or management of massive hemoptysis.