A 45-year-old man from the Southwest presents with fever, cough, and erythema nodosum. Chest X-ray shows hilar lymphadenopathy and a cavitary lesion in the left upper lobe. Sputum culture grows a dimorphic fungus that appears as spherules with endospores at body temperature. Which of the following is the most appropriate initial treatment?

  1. A)Terbinafine
  2. B)Nystatin oral suspension
  3. C)Amphotericin B followed by itraconazoleGABARITO
  4. D)Griseofulvin
  5. E)Fluconazole

Explicação

Coccidioidomycosis (caused by Coccidioides immitis) presents with cavitary pneumonia in the Southwest. The spherule-endospore morphology is pathognomonic. Severe pulmonary coccidioidomycosis requires amphotericin B induction followed by azole therapy (itracona... Ver explicação completa e trilha adaptativa →

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