A 29-year-old man presents with a 2-week productive cough, fever to 38.5°C, and dyspnea after cleaning an abandoned chicken coop in the Ohio River Valley. Vital signs show HR 102/min, RR 22/min, BP 128/76 mmHg, SpO2 92% on room air. Chest X-ray reveals patchy infiltrates and hilar lymphadenopathy. Tuberculin skin test is negative. He denies antibiotic use. Which organism most likely explains his clinical presentation?
- A)Coccidioides immitis
- B)Pneumocystis jirovecii
- C)Blastomyces dermatitidis
- D)Histoplasma capsulatumGABARITO
- E)Cryptococcus neoformans
Explicação
Histoplasma capsulatum is correct. Histoplasmosis is acquired from soil contaminated with bird or bat droppings and is endemic to the Ohio and Mississippi River valleys. It can produce pulmonary symptoms and hilar adenopathy that mimic tuberculosis. Ver explicação completa e trilha adaptativa →