Fungal and Parasitic Infections USMLE Step 1 Practice Question
A 28-year-old man with a history of pulmonary tuberculosis treated 3 years ago presents to the emergency department with a 3-week history of progressive hemoptysis, low-grade fever (38.2Ā°C), and pleuritic chest pain. He works as a grain handler. Vital signs: HR 98/min, RR 20/min, BP 122/80 mmHg, SpO2 93% on room air. He denies immunosuppressive therapy, antiretroviral use, or antifungal prophylaxis. Chest X-ray shows a well-circumscribed opacity with an air-crescent sign within a pre-existing left upper lobe cavitary lesion. Sputum microscopy reveals septate, acutely branching hyphae. Which of the following is the most likely diagnosis?
Answer choices
- AMucormycosis with angioinvasion
- BCandida albicans with esophageal involvement
- CAspergillus fumigatus colonization with mycetoma formationCorrect answer
- DBlastomyces dermatitidis with cavitary disease
- ECryptococcus neoformans with meningitis
- FPneumocystis jirovecii pneumonia with cystic disease
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