A 34-year-old woman with HIV/AIDS (CD4 count 85 cells/μL) presents with progressive dyspnea, fever, and dry cough for 3 weeks. Vital signs show temperature 38.5°C, heart rate 108/min, respiratory rate 28/min, and oxygen saturation 88% on room air. Chest X-ray demonstrates bilateral interstitial infiltrates. Sputum staining with silver stain reveals cup-shaped organisms. She denies chest pain. Which of the following is the most likely diagnosis?
- A)Histoplasmosis
- B)Cytomegalovirus pneumonia
- C)Pneumocystis jirovecii pneumoniaGABARITO
- D)Tuberculosis
- E)Aspergillosis
Explicação
PCP presents with progressive dyspnea, fever, and dry cough in severely immunocompromised patients. Silver stain (GMS or Grocott's) reveals the characteristic cup-shaped or bowl-shaped trophozoites. CD4 <200 cells/μL indicates PCP prophylaxis need. Ver explicação completa e trilha adaptativa →