A 54-year-old HIV-positive man arrives at the emergency room complaining of a nonproductive cough, low-grade fevers, and severe lethargy for the previous month. Over the same time frame, he has also shed 3.6 kg (8 lb). The patient does not routinely take antiretroviral medicine and has not seen his primary care physician in several months. Hepatosplenomegaly is discovered on physical examination. Pancytopenia and increased liver aminotransferases are seen in laboratory tests. The material is light microscopically examined after bone marrow aspiration. Which of the following is the most likely cause of this patient's current condition?

Question

A 54-year-old HIV-positive man arrives at the emergency room complaining of a nonproductive cough, low-grade fevers, and severe lethargy for the previous month. Over the same time frame, he has also shed 3.6 kg (8 lb). The patient does not routinely take antiretroviral medicine and has not seen his primary care physician in several months. Hepatosplenomegaly is discovered on physical examination. Pancytopenia and increased liver aminotransferases are seen in laboratory tests. The material is light microscopically examined after bone marrow aspiration.  Which of the following is the most likely cause of this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: At tissue temperatures, Histoplasma capsulatum is a dimorphic fungus that appears as a tiny, ovoid yeast. It spreads via the lymphatic and reticuloendothelial systems after replicating within macrophages. Immunocompetent people often have an asymptomatic lung infection, but immunocompromised patients (for example, those with advanced AIDS) might have disseminated illness to the liver, spleen, and bone marrow.

A 54-Year-Old HIV-Positive Man Arrives at the Emergency Room Complaining