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Diabetic. Had chest x-rays. Using Froadil Aerolizer inhaler and Combivent respimat. Could be Blastomycosis?

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My husband can't get air. He had chest xrays , he is using Froadil Aerolizer inhaler,Combivent respimat, yesterday they gave him a week supply of azithromycin. Nothing is helping him. He is a diabetic on inslin. Could he have Blastomycosis? Where can he be checked for this? YYYY@YYYY XXXXX
Posted Tue, 13 Aug 2013 in Lung and Chest disorders
Answered by Dr. Vakul Aren 1 hour later

Since your husband is a diabetic and a patient of COPD, his immunocompromised condition makes him vulnerable to many diseases including fungal respiratory infections. Blastomycosis and similar other fungal infections will need to be ruled out - a high index of suspicion is required if the respiratory function is not improving. These fungal infections may cause fungal pneumonia which is often missed.

He would need to be examined by a Respiratory Medicine specialist who may perform a bronchoscopy. The bronchoscopy will include collection of Bronchio-Alveolarlar Lavage fluid which will be sent for investigation. The investigations will include gram staining and culture for bacteria/tubercolosis/fungal cultures , a wet slide of tracheal secretions may also show hyphae and spores of any fungal infection. The fungii and hyphae may occasionally be seen on sputum examination. If no fungii are seen ,it would rule out any fungal infection including Blastomycosis.

Respiratory physiotherapy, oxygen inhalations may supplement the therapy helping him breathe easier.

Hope this answers your query. Let me know if you need clarifications.

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