Pulmonary Pathology

For each of the following clinical histories, match the most closely related infectious organism involving the respiratory tract:

1. A 56-year-old man has developed profound neutropenia following chemotherapy for leukemia. He develops a cough with fever. A chest radiograph reveals multiple 1 to 2 cm nodules scattered throughout all lung fields. A bronchoalveolar lavage yields a sample that on cytologic smear has numerous septate, branching hyphae:

2. A 51-year-old man has a three month history of fever, night sweats, and weight loss. In the past month he experienced episodes of hemoptysis. A chest radiograph reveals bilateral upper lobe cavitations. His HIV test is negative. He does not have a history of prior pulmonary disease:

3. A 48-year-old man has fever with non-productive cough for 3 weeks. A chest radiograph shows a nodular pattern of infiltrates in both lungs. A sputum sample stained with GMS shows cells with broad-based budding:

4. A 63-year-old woman develops fever with non-productive cough for the past 4 days. On examination her lungs have fine crackles with auscultation. A chest x-ray shows diffuse interstitial infiltrates. She recover in 2 weeks with supportive care:

5. A 44-year-old HIV positive man has fever, cough, and dyspnea for 3 days. A chest x-ray shows bilateral infiltrates. Bronchoalveolar lavage yields large cells with prominent intranuclear inclusions:

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A. Aspergillus fumigatus B. Blastomyces dermatitidis C. Candida albicans D. Coccidioides immitis
E. Cryptococcus neoformans F. Cytomegalovirus G. Histoplasma capsulatum H. Influenza A
I. Legionella pneumophila J. Mycobacterium tuberculosis K. Mycoplasma pneumoniae L. Nocardia braziliensis asteroidies
M. Pneumocystis jiroveci (carinii) N. Respiratory syncytial virus O. Staphylococcus aureus P. Streptococcus pneumoniae


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