Reference no: EM133264065

Assignment:

PLEASE READ AND ANSWER IN COMPLETE SENTENCES

A 72-year-old man arrives at a hospital emergency room with signs and symptoms of serious pulmonary infection. He com- plains of a deep cough, blood- tinged sputum, night sweats, and weight loss. His liver and spleen feel enlarged upon physi- cal examination. X-ray studies of his chest suggest tuberculosis, but a tuberculin skin test is negative, as is an HIV test. The man, an Ohio native, has recently traveled to Africa and Asia. In addition, he is an avid bird enthusiast who likes to feed pigeons. He also keeps many bird feeders on his balcony, which attracts numerous birds, and he spends an hour a day cleaning up bird droppings.

Skin tests are positive for histoplasmosis but inconclusive for coccidioidomycosis and blastomycosis.

1. What is the most likely infecting agent? How do you suppose this individual acquired the disease?

2. Is this disease unusual in people who work with birds?

3. Given that some tests were inconclusive, what other tests or lab work would aid in arriving at a specific diagnosis?

4. What treatment would most likely be prescribed?