Monitoring
Regardless of whether patients are actively treated‚ ongoing follow-up should be arranged to assess for improvement or stabilization in clinical symptoms, and monitor radiographic abnormalities and complement fixation serologic titer.
Initially, a patient may require follow-up every 2 to 4 weeks, but as they improve, the interval can be increased to every 3 to 4 months. Following an initial response, changes in serologic and radiographic findings may improve only slowly with time and changes might not be appreciated in less than 3 months.
Depending on the severity of initial findings, radiographic and serologic abnormalities, and resolution of abnormalities, follow-up for 1 to 2 years is recommended.
For patients with severe infection, immunosuppression, or other risk factors for dissemination, lifelong follow-up may be required. In patients discontinuing treatment, follow-up to detect relapsed infection is important.
This disease is nationally notifiable and is reportable in the following states: Arizona, Arkansas, California, Delaware, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Utah, Washington, and Wyoming.
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