Mediastinal and hilar lymphadenopathy in a patient with arthralgias who recently returned from extensive hiking in the Southwest United States raises the question of infection by which of the following organisms?

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Quizplus · Accepted Answer

The patient's history of extensive hiking in the Southwest United States suggests exposure to Coccidioides immitis, a dimorphic fungus endemic to the region that can cause pulmonary infection and mediastinal/hilar lymphadenopathy. Pneumocystis carinii and Cryptococcus neoformans can also cause respiratory infections in immunocompromised patients, but they are not typically associated with lymphadenopathy. Echinococcus granulosis, a tapeworm commonly found in dogs and farm animals, causes liver or lung cysts, but not mediastinal/hilar lymphadenopathy.

Mediastinal and Hilar Lymphadenopathy in a Patient with Arthralgias Who