A 34-year-old woman returns from a caving trip with fever, cough and bilateral hilar lymphadenopathy. CT shows diffuse small nodules and urine

Question

A 34-year-old woman returns from a caving trip with fever, cough and bilateral hilar lymphadenopathy. CT shows diffuse small nodules and urine antigen is positive for Histoplasma. She is immunocompetent but hypoxaemic with diffuse pulmonary infiltrates. What is the most appropriate management?

Accepted Answer

Itraconazole or amphotericin depending severity after infectious diseases review

Answer

Omalizumab for allergic fungal airway disease

Answer

RIPE therapy for presumed tuberculosis

Answer

Observation without follow-up because the antigen is positive

Answer

Prednisolone alone for presumed sarcoidosis

Pulmonary histoplasmosis — SCE Respiratory MCQ

A 34-year-old woman returns from a caving trip with fever, cough and bilateral hilar lymphadenopathy. CT shows diffuse small nodules and urine antigen is positive for Histoplasma. She is immunocompetent but hypoxaemic with diffuse pulmonary infiltrates. What is the most appropriate management?