A 32-year-old woman with HIV presents to the emergency department with a 2-week history of progressive dyspnea, fever, and nonproductive cough. She reports no antiretroviral therapy or prophylactic medication use. Vital signs: temperature 38.5°C, heart rate 108/min, respiratory rate 28/min, oxygen saturation 88% on room air. Physical examination reveals bilateral fine crackles on auscultation. Chest X-ray shows bilateral interstitial infiltrates with a ground-glass appearance. Laboratory studies reveal CD4+ count of 80/μL, lactate dehydrogenase 450 U/L, and negative sputum acid-fast bacilli smears. Which of the following is the most likely diagnosis?
- A)Pneumocystis jirovecii pneumonia (PCP)GABARITO
- B)Tuberculosis with interstitial presentation
- C)Mycobacterium avium complex (MAC) pulmonary disease
- D)Cytomegalovirus pneumonitis
- E)Cryptococcal pneumonia
Explicação
Pneumocystis jirovecii pneumonia (PCP) is the most likely diagnosis given the clinical presentation in a severely immunocompromised patient (CD4 <100/μL) with subacute onset (2 weeks) of dyspnea, fever, and nonproductive cough. The bilateral interstitial/groun... Ver explicação completa e trilha adaptativa →