A 42-year-old pigeon breeder presents with acute onset of fever (38.9°C), chills, and dyspnea 4 hours after cleaning his loft. Vitals show HR 110, RR 28, SpO2 88% on room air. Chest X-ray demonstrates diffuse ground-glass opacities bilaterally. PFTs reveal reduced FVC (65% predicted) with FEV1/FVC ratio of 78%. Serum IgG antibody to pigeon antigen is elevated. No recent medication use. Which of the following is the most likely diagnosis?

  1. A)Coccidioidomycosis
  2. B)Avian influenza
  3. C)Idiopathic pulmonary fibrosis
  4. D)Acute hypersensitivity pneumonitisGABARITO
  5. E)Atypical pneumonia

Explicação

Acute hypersensitivity pneumonitis (extrinsic allergic alveolitis) occurs within hours of antigen exposure (pigeon proteins/droppings). Presents with fever, dyspnea, and restrictive pattern with ground-glass opacities. Symptoms may resolve with antigen avoidan... Ver explicação completa e trilha adaptativa →

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