A 9-year-old boy from Nigeria with sickle cell disease presents with fever (38.9°C), productive cough, and pleuritic chest pain. Vital signs show HR 112, RR 24, BP 105/68, SpO2 94% on room air. Chest X-ray reveals a thin-walled cavitary lesion in the right upper lobe. Blood cultures grow a dimorphic fungus converting to mold at room temperature. Sputum smear is negative for acid-fast bacilli. Which of the following is most likely?
- A)Histoplasma capsulatumGABARITO
- B)Blastomyces dermatitidis
- C)Aspergillus fumigatus
- D)Cryptococcus neoformans
- E)Coccidioides immitis
Explicação
Histoplasma capsulatum is endemic to Nigeria and causes disseminated histoplasmosis in sickle cell patients. It is dimorphic (yeast at 37°C, mold at 25°C). Blood cultures may grow the organism in disseminated disease. Cavitary lesions can occur. Ver explicação completa e trilha adaptativa →