A 68-year-old man with COPD and prior pulmonary tuberculosis presents with hemoptysis and dyspnea. Vitals: BP 138/82, HR 92, RR 22, Temp 37.2°C, SpO2 88% on room air. High-resolution CT chest shows a 3-cm cavitary lesion with an intracavitary mobile mass. Sputum culture grows septate hyphae with acute-angle branching. Chest X-ray shows no pneumothorax. He denies fever or weight loss. Which organism is most likely responsible?
- A)Mucormycosis
- B)Coccidioidomycosis
- C)Histoplasmosis
- D)Acute invasive aspergillosis
- E)AspergillomaGABARITO
Explicação
Aspergilloma (fungal ball) occurs in pre-existing cavitary lung lesions from TB or COPD. Aspergillus fumigatus colonizes the cavity, forming a mobile mass ('air crescent' sign). Septate hyphae with acute angle branching are pathognomonic. Hemoptysis results fr... Ver explicação completa e trilha adaptativa →