Mr. K. had renal transplant surgery 6 months ago and so far has had no problems with organ rejection. He is taking cyclosporine (Sandimmune) in a maintenance dose. He wants to go back to work and is in for a checkup before approval is given for a return to his job.
QUESTIONS:
He asks if he will have to continue the cyclosporine. What is your response?
He complains of difficulty swallowing, and as you examine his mouth, you look for signs of oral candidiasis. What findings would indicate that he has this condition?
After 2 weeks at work, Mr. K. calls to report that he has the flu. He has a sore throat, chills, and achy joints, and he is very tired. What is your advice?
Mr. K. tells you that his job sometimes requires him to travel to remote areas of the world. What concerns are there with vaccinations, if any?