A 46-year-old woman presents with fever, hemoptysis, weight loss, and night sweats. She has never smoked. She recently returned returned from a month-long trip to Asia. A chest radiograph reveals apical lesions with cavitation in the left lung. A purified protein derivative (PPD) test is placed, and 48 hours later an 18-mm wheal develops. Sputum cultures reveal numerous acid-fast organisms. This patient is put on ontact precautions, and a regimen for tuberculosis is staed. Which of the following disorders does this patient most likely have?
Tuberculosis, at one time a frequent hazard in the United States, is now relatively uncommon except in immunocompromised individuals Primary tuberculosis is the initial infection by M. tuberculosis, and is restricted to the primary, or Ghon complex. Cavitation and selective localization to the pulmonary apices are characteristics of secondary tuberculosis. Secondary tuberculosis may spread through the lymphatics and blood to other organs, resulting in miliary tuberculosis
Acquired immunodeficiency syndrome
Congenital immunodeficiency
Miliary tuberculosis, with seeding of distal organs with innumerable small millet seed-like lesions
Secondary tuberculosis, resulting from activation of a prior Ghon complex, with spread to a new pulmonary site
Systemic Pathology