Fungal and Parasitic Infections USMLE Step 1 Practice Question
A 24-year-old male construction worker from Brazil presents with a 3-month history of progressive facial swelling, difficulty swallowing, and painful oral ulcerations. He reports working in areas with high humidity and soil exposure. Vital signs are stable (BP 118/76, HR 88, RR 16, Temp 37.2°C). Physical examination reveals granulomatous lesions with linear scarring on the lips and oral mucosa. Histopathology from a lip biopsy shows granulomatous inflammation with fungal elements demonstrating a characteristic "pilot-wheel" or "ship's wheel" appearance with central asteroid bodies. Fungal culture is pending. Which of the following is the most likely diagnosis?
Answer choices
- AChromoblastomycosis
- BSporotrichosis
- CCoccidioidomycosis
- DParacoccidioidomycosisCorrect answer
- EBlastomycosis
- FHistoplasmosis
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