A 32-Year-Old Woman Comes to the Hospital Complaining of Fever

question 943

Multiple Choice

A 32-year-old woman comes to the hospital complaining of fever, chills, pleuritic chest pain, and shortness of breath for the last 3 days.  She was found to be HIV positive 1 year ago; her CD4 count was 378/µL about 1 month ago.  The patient does not regularly attend clinic appointments and takes no medications.  She uses intravenous heroin and cocaine.  Her only sexual partner is also HIV positive.  Her temperature is 39.3° C (102.7° F) , blood pressure is 120/68 mm Hg, pulse is 110/min, and respirations are 22/min.  Examination shows scattered crackles in both lung fields.  Her abdomen is soft and nontender without hepatosplenomegaly.  Her extremities exhibit several needle marks.  Laboratory results are as follows: Imaging of the chest reveals multiple nodular lesions with small cavities, as shown below.
Which of the following organisms is most likely responsible for this patient's current condition?

• A)Haemophilus influenzae
• B)Legionella pneumophila
• C)Mycobacterium tuberculosis
• D)Pneumocystis jiroveci
• E)Staphylococcus aureus
• F)Staphylococcus epidermidis
• G)Streptococcus pneumoniae

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Definitions:

Deployment

The act of moving military personnel and equipment to a specific location to achieve strategic objectives.

Increased

Describes something that has grown or risen in amount, intensity, or extent.

Between 2008 And 2011

A time frame referring to the years starting from 2008 and ending in 2011, often used to specify or demarcate a period for analysis or events.

Self-Defense

The act of protecting oneself from harm using reasonable force, especially from immediate physical threat.