A 34-year-old woman with a 12-year history of moderate persistent asthma presents to the emergency department with acute-onset severe dyspnea, unilateral left pleuritic chest pain, and hemoptysis. She reports a 3-week prodrome of low-grade fever, malaise, and progressive dyspnea despite adherence to her inhaled corticosteroid and long-acting beta-agonist. Vital signs: BP 128/82 mmHg, HR 118 bpm, RR 28/min, SpO2 88% on 2L nasal cannula. She denies recent trauma, immobilization, or oral contraceptive use. Physical examination reveals decreased breath sounds at the left lung base with crackles. Chest X-ray shows a new left lower lobe consolidation with bronchial wall thickening. Laboratory studies: WBC 11,200/μL, IgE 680 IU/mL (normal <100), serum eosinophils 8% (normal <4%). Sputum cultures are pending. Which of the following complications most likely explains her clinical presentation?

1. A)Acute asthma exacerbation with status asthmaticus
2. B)Pulmonary embolism with secondary pneumonia
3. C)Aspiration pneumonia with bronchospasm
4. D)Community-acquired bacterial pneumonia
5. E)Allergic bronchopulmonary aspergillosis (ABPA)GABARITO