A 26-year-old man presents with fever (38.8°C), productive cough, and malaise 2 weeks after cleaning a chicken coop in the Ohio River valley. Vital signs show BP 118/76, HR 92, RR 18, SpO2 98% on room air. Chest X-ray reveals bilateral hilar lymphadenopathy. Bronchoalveolar lavage demonstrates small oval yeasts within macrophages. Fungal culture shows growth on Sabouraud medium. He denies night sweats or hemoptysis. Which organism is most likely responsible?
- A)Histoplasma capsulatumGABARITO
- B)Coccidioides immitis
- C)Cryptococcus neoformans
- D)Blastomyces dermatitidis
- E)Sporothrix schenckii
Explicação
Histoplasma capsulatum is a dimorphic fungus found in soil enriched with bird or bat droppings and is endemic in the Ohio and Mississippi River valleys. In tissue it appears as small intracellular yeasts within macrophages and can mimic tuberculosis with hilar... Ver explicação completa e trilha adaptativa →