A 28-year-old male spelunker from Ohio presents one week after exploring bat-infested caves with fever (38.9°C), productive cough, and pleuritic chest pain. Vital signs show BP 128/82, HR 102, RR 20, SpO2 94% on room air. Chest X-ray demonstrates patchy alveolar infiltrates with hilar lymphadenopathy. Laboratory studies reveal elevated transaminases (AST 78 U/L). He denies hemoptysis. Which organism most likely caused this infection?
- A)Histoplasma capsulatumGABARITO
- B)Coccidioides immitis
- C)Tuberculosis
- D)Pneumocystis jirovecii pneumonia
- E)Blastomyces dermatitidis
Explicação
Histoplasma capsulatum is correct. Exposure to bat droppings in the Ohio River valley is a classic clue, and histoplasmosis can present with pulmonary infiltrates and hilar adenopathy. The organism resides in macrophages as small oval yeasts. Ver explicação completa e trilha adaptativa →