A 35-year-old man from Ohio presents with fever (38.8°C), productive cough, and dyspnea after exploring a bat cave 3 weeks ago. Vital signs show HR 102/min, RR 22/min, SpO2 94% on room air. Chest X-ray reveals hilar lymphadenopathy with right upper lobe infiltrate. Sputum culture on Sabouraud agar at 25°C grows mold displaying tuberculate macroconidia. He denies hemoptysis. What is the most likely organism?
- A)Cryptococcus neoformans
- B)Histoplasma capsulatumGABARITO
- C)Aspergillus fumigatus
- D)Coccidioides immitis
- E)Blastomyces dermatitidis
Explicação
Histoplasma capsulatum is endemic in the Ohio and Mississippi river valleys, found in bat/bird droppings. Tuberculate macroconidia on culture at 25C are diagnostic. It is a dimorphic fungus (mold at 25C, yeast at 37C). Ver explicação completa e trilha adaptativa →