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Topics:
General Internal Medicine
•
Infectious Disease
•
Pulmonology
•
Pulmonary Infections
Would you treat a sputum culture positive for Aspergillus niger despite an atypical CT chest and a negative serum galactomannan in an immunosuppressed patient who is too high risk for bronchoscopy?
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In light of recent measles outbreaks in the US, would you recommend an MMR booster for an immunocompetent patients born before 1957?
What further evaluation do you pursue for patients who present with vague symptoms such as subjective fevers or intermittent night sweats, who have no pulmonary symptoms but have a positive IGRA?
Would you start treatment for MAC in a patient with nodular bronchiectatic disease who has demonstrated radiographic progression but remains asymptomatic and smear-negative?
What is the interpretation of two IGRAs with negative mitogen wells, in the absence of immunosuppression?
What is the interpretation of an IGRA with positive TB wells and negative nil and negative mitogen wells?
Do you treat non-albicans strains of Candida on sputum culture or BAL in patients who are immunosuppressed?
How would you treat an asymptomatic patient with a positive Blastomyces antibody, evidence of prior granulomatous lung disease on imaging, and who may require immunosuppression in the future?
Do you consider the use of tocilizumab in patients with COVID pneumonia who have had an improvement in supplemental O2 requirements but have significantly elevated inflammatory markers after day two of remdesivir and dexamethasone?
Is the combination of a negative BAL PJP PCR and normal fungitell enough to rule out PJP pneumonia in an at-risk non-HIV patient?
Do you treat complicated pneumonia with a drained empyema longer if Streptococcus anginosus is cultured, either in isolation or with other organisms, compared to cases in which it is not?