A 54-Year-Old Man with HIV Comes to the Emergency Department

question 207

Multiple Choice

A 54-year-old man with HIV comes to the emergency department due to nonproductive cough, low-grade fevers, and worsening fatigue for the past month.  He has also lost 3.6 kg (8 lb) over the same period.  The patient does not take antiretroviral therapy consistently and has not followed up with his primary care physician for the past several months.  Physical examination reveals hepatosplenomegaly.  Laboratory testing shows pancytopenia and elevated liver aminotransferases.  Bone marrow aspiration is performed, and light microscopy of the specimen is shown below. Which of the following is the most likely cause of this patient's current condition?

• A)Aspergillus fumigatus
• B)Blastomyces dermatitidis
• C)Candida albicans
• D)Coccidioides immitis
• E)Cryptococcus neoformans
• F)Histoplasma capsulatum