A 56-Year-Old Man with Advanced AIDS Comes to the Emergency

A 56-year-old man with advanced AIDS comes to the emergency department due to several weeks of progressive fever, night sweats, weight loss, diarrhea, and generalized weakness.  Physical examination shows mucosal pallor, generalized lymphadenopathy, and hepatosplenomegaly.  Laboratory studies reveal anemia and elevated alkaline phosphatase and lactate dehydrogenase levels.  CD4 count is 16/mm³.  Bone marrow biopsy shows aggregates of epithelioid histiocytes with foamy cytoplasm and numerous acid-fast intracellular organisms.  Nucleic acid amplification test of the sample for Mycobacterium tuberculosis is negative.  Which of the following pathogens is the most likely cause of this patient's illness?

A) Cryptococcus neoformans
B) Cryptosporidium parvum
C) Legionella pneumophila
D) Mycobacterium avium
E) Mycobacterium marinum
F) Nocardia asteroides

Correct Answer:

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