A 28-year-old man with a history of pulmonary tuberculosis treated 3 years ago presents to the emergency department with a 3-week history of progressive hemoptysis, low-grade fever (38.2°C), and pleuritic chest pain. He works as a grain handler. Vital signs: HR 98/min, RR 20/min, BP 122/80 mmHg, SpO2 93% on room air. He denies immunosuppressive therapy, antiretroviral use, or antifungal prophylaxis. Chest X-ray shows a well-circumscribed opacity with an air-crescent sign within a pre-existing left upper lobe cavitary lesion. Sputum microscopy reveals septate, acutely branching hyphae. Which of the following is the most likely diagnosis?
- A)Mucormycosis with angioinvasion
- B)Candida albicans with esophageal involvement
- C)Aspergillus fumigatus colonization with mycetoma formationGABARITO
- D)Blastomyces dermatitidis with cavitary disease
- E)Cryptococcus neoformans with meningitis
Explicação
Aspergillus fumigatus aspergilloma (fungal ball/mycetoma) is the classic presentation of a mobile, well-circumscribed lesion within a pre-existing cavity with the pathognomonic air-crescent sign on imaging. Septate, acutely branching hyphae in sputum are chara... Ver explicação completa e trilha adaptativa →