Which of the following organisms can cause infection to him?
A 25-year-old man receives a bone marrow transplant for treatment of acute myelogenous leukemia. He develops increasing dyspnea 3 weeks later, along with fever and cough. On physical examination his temperature is 37.8 C. A chest radiograph shows irregular interstitial infiltrates. A bronchoalveolar lavage is performed an on cytologic examination shows cells that are enlarged and have prominent intranuclear inclusions.
A. Toxoplasma gondii B. Candida albicans C. Cytomegalovirus D. Pneumocystis carinii (jirovecii) E. Mycobacterium tuberculosis F. Influenza B virus G. Respiratory syncytial virus
Cytomegalovirus -c) correct. cmv produces a cytopathic effect with enlarged cells having prominent intranuclear inclusions.(a) incorrect. toxo is not common in lung. toxo cysts contain bradyzoites, which are about 2 microns in size. there may be surrounding free tachyzoites of the same size as bradyzoites.(b) incorrect. candida yields budding cells and pseudohyphae.(d) incorrect. pcp yields foamy material that appears acellular with h&e and pap stains.(e) incorrect. tb produces a granulomatous reaction. there may be giant cells of the langhans variety, but a bal will probably not have much that is diagnostic without an afb stain or culture.(f) incorrect. influenza virus infections are not characteristic for immunocompromised patients. no characteristic inclusions can be seen in specimens.(g) incorrect. respiratory syncytial virus infections are most common in young children and infants. they are not characteristic for immunocompromised patients. inclusions are in the cytoplasm with this rna virus.