A 53-Year-Old Man Comes to the Emergency Department Due to Progressively

question 210

Multiple Choice

A 53-year-old man comes to the emergency department due to progressively worsening shortness of breath, nonproductive cough, and low-grade fevers over the past 2 weeks.  He has not had a runny nose or sore throat and does not recall any sick contacts.  He received a lung transplant for idiopathic pulmonary fibrosis 4 months ago.  His medications include immunosuppressants and trimethoprim-sulfamethoxazole.  Temperature is 37.8 C (100 F) .  Chest x-ray reveals diffuse interstitial infiltrates bilaterally.  A decrease in pulmonary function is noted on testing.  A lung biopsy specimen is shown below. Which of the following best characterizes the organism most likely responsible for this patient's current condition?

• A)Enveloped double-stranded DNA virus
• B)Enveloped single-stranded RNA virus
• C)Filamentous gram-positive rods
• D)Nonenveloped double-stranded DNA virus
• E)Nonenveloped single-stranded RNA virus
• F)Trophic and cystic fungal forms

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