A 37-year-old man with untreated HIV presents with progressive dyspnea, dry cough, and fever for 2 weeks. Vital signs: BP 118/76, HR 102, RR 28, Temp 38.5°C, SpO2 88% on room air. CD4 count is 80 cells/mm³. Chest radiograph shows diffuse bilateral interstitial infiltrates. Lactate dehydrogenase is elevated at 520 U/L. Sputum cultures are negative. Which of the following is the most likely diagnosis?
- A)Histoplasma capsulatum
- B)Community acquired pneumonia
- C)Legionella pneumophila
- D)Pneumocystis jirovecii pneumoniaGABARITO
- E)Pulmonary embolism
Explicação
Pneumocystis jirovecii pneumonia is correct. Advanced HIV with CD4 count below 200, elevated LDH, dry cough, and diffuse bilateral interstitial infiltrates is classic. This opportunistic pneumonia causes hypoxemia and is typically diagnosed with induced sputum... Ver explicação completa e trilha adaptativa →