Saturday, April 16, 2016

Herpes contamination during travel_Health awareness

The patient recently took a trip to Hawaii which was a cruise.  She departed from California port of call and stopped in Hawaii after 4 days in that ship.  There were no exposures to wild life or exotic situations, but there was what seemed like a viral sinus infection that her husband contracted and he is still ill.  He initially received antibiotics from the cruise physician and he started to feel slightly better, but not completely and receive stronger antibiotics when he got here from his primary care physician.  He is still somewhat ill, but is going to work and is recuperating.  She then contracted her illness and became much more ill.  She did not have hemoptysis, but had a productive cough.  She has wheezing, shortness of breath, dyspnea that had been worsening over the last week that started 6-7 days ago and continue to worsen such that she came at hospital.  After admission, she had, on CAT scan imaging, to be found bilateral infiltrates and received antibiotic therapy.  She was started on azithromycin and Rocephin that has been continued and she does feel better and she does that her energy level has improved significantly, but she still having a lot of phlegm production.  She cannot sleep flat due to the congestion.  She is receiving nebulizer treatments appropriately and due to wheezing and shortness of breath and congestion.  She was started on steroid prednisone orally, which has then been tapered yesterday.  She states that the nebulizers help her bring a lot of mucus production up and she is feeling better from that perspective.  She has not had a leukocytosis other than recently and it has been worsening over the last 2-3 days, but the prednisone confounds that interpretation.  

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