A 22-year-old man with AIDS complains of persistent cough, night sweats, low-grade fever, and general malaise. A chest X-ray reveals an area of consolidation in the periphery of the left upper lobe, as well as hilar lymphadenopathy. Sputum cultures show acid-fast bacilli. Which of the following is the most likely diagnosis?
Bronchopneumonia
Pulmonary abscess
Sarcoidosis
Tuberculosis
Tuberculosis. Tuberculosis represents infection with Mycobacterium tuberculosis, although atypical mycobacterial infections may mimic it. The Ghon complex includes parenchymal consolidation and enlargement of ipsilateral hilar lymph nodes and is often accompanied by a pleural effusion. The sputum contains M. tuberculosis, which is acid-fast in smears stained by the Ziehl-Neelsen technique. After resolution of primary tuberculosis, reemergence may occur (secondary tuberculosis). None of the other choices feature acid-fast organisms.Diagnosis: Tuberculosis, Mycobacterium tuberculosis
Respiration