Chapter·MicrobiologyDimorphic fungi

Environmental sources and preventionDownloads

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1

A 26-year-old man comes to the physician for a follow-up examination. He was diagnosed with HIV infection 2 weeks ago. His CD4+ T-lymphocyte count is 162/mm3 (N ≥ 500). An interferon-gamma release assay is negative. Prophylactic treatment against which of the following pathogens is most appropriate at this time?

ACytomegalovirus

BToxoplasma gondii

CMycobacterium tuberculosis

DAspergillus fumigatus

EPneumocystis jirovecii

2

A 33-year-old HIV-positive male is seen in clinic for follow-up care. When asked if he has been adhering to his HIV medications, the patient exclaims that he has been depressed, thus causing him to not take his medication for six months. His CD4+ count is now 33 cells/mm3. What medication(s) should he take in addition to his anti-retroviral therapy?

AAzithromycin and fluconazole

BAzithromycin, dapsone, and fluconazole

CDapsone

DFluconazole

EAzithromycin and trimethoprim-sulfamethoxazole

3

A 52-year-old man comes to the physician because of a 4-day history of a productive cough, shortness of breath, and low-grade fever. He works as a farmer in southern Arizona. Physical examination shows multiple skin lesions with a dark blue center, pale intermediate zone, and red peripheral rim on the upper and lower extremities. There are diffuse crackles on the left side of the chest. An x-ray of the chest shows left basilar consolidation and left hilar lymphadenopathy. A photomicrograph of tissue obtained from a biopsy of the lung is shown. Which of the following is the most likely causal pathogen?

ACoccidioides immitis

BParacoccidioides brasiliensis

CCandida albicans

DBlastomyces dermatitidis

EAspergillus fumigatus

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