A 42-year-old man from a tuberculosis-endemic region presents with one month of persistent cough, night sweats, and 8-lb weight loss. He reports intermittent hemoptysis but denies dyspnea. Vital signs: BP 128/76, HR 92, RR 18, Temp 37.8°C, SpO2 96% on room air. Chest radiograph reveals cavitary lesions in bilateral upper lobes. Sputum acid-fast bacilli smear is positive. Which of the following is the most likely diagnosis?
- A)Reactivation tuberculosisGABARITO
- B)Primary tuberculosis
- C)Sarcoidosis
- D)Lung abscess from aspiration
- E)Histoplasmosis
Explicação
Reactivation tuberculosis preferentially involves the oxygen rich apical upper lobes and commonly causes fever, night sweats, weight loss, and hemoptysis. Cavitary lesions are typical because of caseating granulomatous destruction. Epidemiologic risk factors s... Ver explicação completa e trilha adaptativa →