A 42-year-old man from Wisconsin presents with a 3-month history of productive cough, unintentional weight loss, and a verrucous skin lesion on his forearm. Vital signs show temperature 38.2°C, BP 128/82, HR 102, RR 20, SpO2 92% on room air. Chest X-ray demonstrates patchy infiltrates in the right upper lobe. Tissue biopsy reveals broad-based budding yeast. Sputum cultures remain negative for acid-fast bacilli. Which of the following is the most likely diagnosis?
- A)Coccidioidomycosis
- B)Aspergillosis
- C)BlastomycosisGABARITO
- D)Cryptococcosis
- E)Histoplasmosis
Explicação
Blastomycosis is correct. Blastomyces dermatitidis is a dimorphic fungus found in the eastern United States and Great Lakes region. Broad based budding yeast on tissue biopsy and pulmonary disease with skin involvement are classic clues. Ver explicação completa e trilha adaptativa →