A 35-Year-Old Man Who Received a Kidney Transplant One Year

A 35-year-old man who received a kidney transplant one year ago comes to the emergency department with pleuritic chest pain and cough.  He is found to have a low-grade fever.  Chest x-ray reveals an infiltrate in the lower lobe of the right lung.  The patient is started on broad-spectrum antibiotics, including vancomycin, ceftriaxone, and azithromycin.  Despite these measures, his condition worsens over the next several days.  Bronchoscopy with bronchoalveolar lavage is performed.  Mucicarmine staining of his bronchoalveolar fluid reveals the following on light microscopy: Which of the following is the most likely cause of this patient's condition?

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

Correct Answer:

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