Pathology MCQ7
Pathology MCQ7:
A 31-year-old HIV-positive man has had increasing respiratory difficulty for the past 2 days. On physical examination, crackles are auscultated over all lung fields. A chest radiograph shows bilateral interstitial infiltrates. Laboratory studies show 26,800 copies of HIV-1 RNA/mL. A transbronchial biopsy is performed; the microscopic appearance of the specimen is shown in the figure. Which of the following is the most likely causative organism of his pulmonary disease?
A Adenovirus
B Cytomegalovirus
C Epstein-Barr virus
D Herpes zoster virus
E Respiratory syncytial virus
Explanation:
This patient has a high HIV-1 RNA level consistent with the diagnosis of AIDS. Although patients with AIDS are susceptible to many microbes, infections with cytomegalovirus are particularly common. The biopsy specimen shows an enlarged cell containing a large, distinct intranuclear inclusion and ill-defined dark cytoplasmic inclusions, which are typical of cytomegalovirus infection.
Adenovirus is a viral pathogen in both immunocompromised and immunocompetent adults that may produce a clinically significant pneumonia, and intranuclear inclusions may be present, but the cells are not large, and cytoplasmic inclusions are absent.
Epstein-Barr virus infection is seen frequently in patients with HIV infection, but there are no distinct pulmonary lesions associated with it.
Herpes zoster infections are most likely to affect the peripheral nervous system, rarely can become disseminated to affect the lungs in immunosuppressed patients, and produce a different appearance than that shown.
Respiratory syncytial virus infections are seen in children, but rarely in adults.
So, the correct option is option B(Cytomegalovirus).
(Image credit:Flickr)
A 31-year-old HIV-positive man has had increasing respiratory difficulty for the past 2 days. On physical examination, crackles are auscultated over all lung fields. A chest radiograph shows bilateral interstitial infiltrates. Laboratory studies show 26,800 copies of HIV-1 RNA/mL. A transbronchial biopsy is performed; the microscopic appearance of the specimen is shown in the figure. Which of the following is the most likely causative organism of his pulmonary disease?
A Adenovirus
B Cytomegalovirus
C Epstein-Barr virus
D Herpes zoster virus
E Respiratory syncytial virus
This patient has a high HIV-1 RNA level consistent with the diagnosis of AIDS. Although patients with AIDS are susceptible to many microbes, infections with cytomegalovirus are particularly common. The biopsy specimen shows an enlarged cell containing a large, distinct intranuclear inclusion and ill-defined dark cytoplasmic inclusions, which are typical of cytomegalovirus infection.
Epstein-Barr virus infection is seen frequently in patients with HIV infection, but there are no distinct pulmonary lesions associated with it.
Herpes zoster infections are most likely to affect the peripheral nervous system, rarely can become disseminated to affect the lungs in immunosuppressed patients, and produce a different appearance than that shown.
Respiratory syncytial virus infections are seen in children, but rarely in adults.
So, the correct option is option B(Cytomegalovirus).
(Image credit:Flickr)
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