This has been a very interesting day. Channel Man Stan's condition is slowly improving. His ventilator was set to 50% FiO2 and the doctors discontinued the infusion of atricurium (the paralytic agent) and Stan's respiratory system is being allowed to start to try and "kick-in" on its own. Although still unconscious, he is starting to cough and his lungs are generating secretions which have to be suctioned on a regular basis. His body reacts during the suction process and you can see him attempting to breathe on his own. It's been almost a week since we've seen self-initiated body movement from him and it's quite a refreshing sight.

Even more exciting was the conversation we had with the Attending Physician in the ICU. He said the bronchial wash cultures came back positive for yeast. This is consistent with a diagnosis of blastomycosis, histoplasmosis, and other diseases caused by dimorphic fungi, which exist as a mold in the environment and then as a pathogenic yeast form in the body. The drug of choice in treating these infections (especially blastomycosis) is itraconazole, which is an anti-fungal agent. The pharmacy at Highland Hospital does not have it in stock, so they are checking with Strong Memorial Hospital to try and locate some and once they receive it they will infuse it immediately. According to Annie Crossby, who is from Grimsby, Ontario and is very knowledgeable on "blasto", itraconazole is fairly fast acting and we should expect to see a significant response to its administration, if in fact blastomycosis is the cause of Stan's condition.

We will be waiting for the results from the tests for antigens associated with blastomycosis and further lab cultures of bronchial wash fluid and blood samples before having a definitive diagnosis, but the Attending Physician in the ICU said that for now they are assuming it to be blastomycosis and will begin treating it accordingly.