cc: cough, fever, dyspnea and wart-like growth on neck HPI: 35-year old otherwise healthy, nonsmoker, male presents to the clinic with complaints of intermittent cough, low-grade fever, and difficulty breathing that has persisted for the past few months. Additionally, he has noticed a nontender wart-like growth on his neck that has increased in size over this period. He reports 5 lb weight loss and has experienced some occasional joint stiffness throughout the day. He drinks 2-3 beers a week, tried marijuana 5 years ago, and denies any IV drug use or time spent in jail. He has worked as a landscaper for the past 10 years and recently moved from Missouri.
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Cc: cough, fever, dyspnea and wart-like growth on neck HPI: 35-year old otherwise healthy, nonsmoker, male presents to the clinic with complaints of intermittent.
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cc: cough, fever, dyspnea and wart-like growth on neckHPI: 35-year old otherwise healthy, nonsmoker, male presents to
the clinic with complaints of intermittent cough, low-grade fever, and difficulty breathing that has persisted for the past few months. Additionally, he has noticed a nontender wart-like growth on his neck that has increased in size over this period. He reports 5 lb weight loss and has experienced some occasional joint stiffness throughout the day. He drinks 2-3 beers a week, tried marijuana 5 years ago, and denies any IV drug use or time spent in jail. He has worked as a landscaper for the past 10 years and recently moved from Missouri.
General-no acute distressHEENT-normocephalic atraumaticNeck-supple, no thyromegaly, no cervical lymphadenopathyCV-tachycardic, regular rhythm, normal S1/S2, no murmurs, rubs, or
gallopsPulmonary-bilateral fine inspiratory cracklesAbdomen-soft, nontender, nondistended, + BS, no hepatosplenomegalyExtremities-no cyanosis, clubbing, or edemaSkin-4-5 cm raised, nontender, verrucous like lesion located on right side
Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. Retrieved November 21, 2012 from http://www.accessmedicine.com/content.aspx?aID=9110719.
3 Bradsher Jr., RW. Clinical manifestations and diagnosis of blastomycosis. In: UpToDate, Kauffman, C, Thorner, A, eds. UpToDate, Waltham, MA, 2012
4 Bradsher Jr., RW. Treatment of blastomycosis. In: UpToDate, Kauffman, C, Thorner, A, eds. UpToDate, Waltham, MA, 2012
5 Centers for Disease Control and Prevention. “Histopathology B. dermatitidis.” Online image. http://www.cdc.gov/fungal/blastomycosis/. Accessed on Nov 21, 2012.
6 MedicaLook. “Blastomycosis.” Online image. http://www.medicalook.com/Skin_diseases/Blastomycosis.html. Accessed on Nov 21, 2012.