A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
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Transcript of A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a
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DEBBIE KENNEDY, SPECIALIST ASPERGILLOSIS NURSENATIONAL ASPERGILLOSIS CENTRE
UHSMMANCHESTER
Support Meeting for Aspergillosis Patients
Fungal Research Trust
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A Clinic Visit
4th November 2010
Patient Support Meeting ERC
by Debbie Kennedy
Aspergillosis Specialist Nurse
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Your Clinic Visit
Where National Aspergillosis Centre based in the North West Lung Centre at
University Hospital Manchester
WhenMonday am Wednesday pm Friday am
WhoForeground - Doctors, Specialist Nurses, Administration Manager,
Physiotherapists, Background - Specialist Laboratory staff, Researchers, Website
Information Architect
WhyNationally Commissioned Specialist Service to deliver all aspects of
Aspergillosis Care
HowFace to face Multidisciplinary Team approachNurse driven telephone support service
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Your Clinic Visit
What Happens?
Welcomed Weight MRC Dyspnoea (breathlessness) score Quality of Life Questionnaire History Chest Examination Chest X-ray CT Scan Lung Function Studies Bronchoscopy Specialist Aspergillus Tests Information Giving Avoidance
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Vignettewith
Georgina and Marie Aspergillosis Specialist Nurses
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MRC Breathlessness Scale
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History – Past & Recent
Who gets Aspergillosis
Inhalation of aspergillus spores is a common daily occurrence.
A healthy immune system would normally remove the spores and no symptoms or infection would occur.
In individuals whose immune system may be suppressed either because of illness e.g. AIDS, cancer patients or drugs, spores may germinate and resulting tissue or systemic aspergillus invasion can result.
Individuals with allergies such as asthma, can also be vulnerable to aspergillus disease.
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History
Signs and SymptomsWeight loss 16 / 18 (89%)Cough 15 / 18 (83%)Shortness of breath 9 / 18 (50%)Haemoptysis 9 / 18 (50%)Fatigue / malaise 5 / 18 (28%)Chest pain 3 / 18 (17%)Sputum production ++ 3 / 18 (17%)Fever 2 / 18 (11%)
Denning DW et al, Clin Infect Dis 2003; 37:S265
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Chest Examination
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Vignettewith
Georgina and Marie Aspergillosis Specialist Nurses
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Chest X-ray
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Chest Xray Aspergilloma
Fungal Ball
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Chest CT scan
Fungal Ball
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Lung Function Studies
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Lung Function Studies
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Bronchoscopy
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Vignettewith
Georgina and Marie Aspergillosis Specialist Nurses
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Specialist Aspergillus Tests
Sputum test
Fungal Culture and Sensitivity
Sputum PCR
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Sputum Fungal Culture
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Your Clinic Visit
What Happens?
Blood tests Liver Function test Kidney function test Glucose Full Blood Count – anaemia, infection Immune system Inflammatory markers Allergy Levels Drug Monitoring Levels Vitamin D Levels Research Bloods
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Vignettewith
Georgina and Marie Aspergillosis Specialist Nurses
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Specialist Aspergillus Tests
Blood test
Aspergillus precipitins (IgG) and titre
Total Immunoglobulin E (IgE)
Aspergillus specific IgE (RAST)
Drug Monitoring Levels
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Information
Contact Information Information Leaflets Website Information Smoking Cessation Physiotherapist Advice Aspergillus Avoidance
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Vignettewith
Georgina and Marie Aspergillosis Specialist Nurses
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How to avoid Aspergillus
Pulmonary infections can be prevented by Avoid smoking Do not use bedside humidifiers
Sources of Aspergillus spores animal stables Hay Mulch rotten plants, compost piles, wood chips construction sites
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Where is Aspergillosis
Sources of Infection?
Aspergillus species are found in:
Soil Air; spores may be inhaled Water / storage tanks in hospitals etc Food Compost and decaying vegetation Fire proofing materials Bedding, pillows Ventilation and air conditioning systems Computer fans
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www.aspergillus.org.uk
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Thank you