A 45-year-old man comes to the urgent care clinic because of fever, severe headache, myalgia, and pleuritic chest pain. He has had these symptoms for several days. Physical examination shows fever and mild tachycardia. Lung auscultation reveals mild crackles. Radiographic examination is consistent with segmental pulmonary infiltrates. The patient fails to respond to empiric antibacterial antibiotic therapy. Microscopic examination of lung tissue obtained from this patient shows spherules packed with endospores. This patient's history is most likely to reveal which of the following?

Question

A 45-year-old man comes to the urgent care clinic because of fever, severe headache, myalgia, and pleuritic chest pain.  He has had these symptoms for several days.  Physical examination shows fever and mild tachycardia.  Lung auscultation reveals mild crackles.  Radiographic examination is consistent with segmental pulmonary infiltrates.  The patient fails to respond to empiric antibacterial antibiotic therapy.  Microscopic examination of lung tissue obtained from this patient shows spherules packed with endospores.  This patient's history is most likely to reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Coccidioides immitis is a dimorphic fungus endemic to the southwestern United States.  It exists in the environment as a mold (with hyphae) that forms spores.  These spores are inhaled and turn into spherules in the lungs.

A 45-Year-Old Man Comes to the Urgent Care Clinic Because