A 28-year-old man recently returned from caving in Arizona presents with a 2-week history of productive cough and fever (38.5°C). Vital signs show HR 102 bpm, RR 20/min, BP 118/76 mmHg, and SpO2 98% on room air. Chest X-ray demonstrates hilar lymphadenopathy without cavitary lesions. Sputum culture grows a dimorphic fungus appearing as small spheres containing endospores at 37°C. He denies hemoptysis. Which of the following is the most likely diagnosis?
- A)Histoplasmosis
- B)CoccidioidomycosisGABARITO
- C)Tuberculosis
- D)Aspergillosis
- E)Blastomycosis
Explicação
Coccidioides immitis is a dimorphic fungus endemic to the American Southwest (Arizona, California). Spherules containing endospores at body temperature are pathognomonic. Primary infection presents as pneumonitis with hilar lymphadenopathy. Exposure via spore ... Ver explicação completa e trilha adaptativa →