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5. Pneumocystis jirovecii pneumonia
Pneumocystis jirovecii pneumonia commonly presents as multifocal, bilateral ground-glass opacity; focal cavitary lung disease would be an extremely unusual presentation for this infection. The other choices commonly present with focal cavitary lung disease and certainly could affect an immunocompromised transplant recipient.
The patient underwent sputum induction which revealed both rhinoviral and enteroviral RNA. The patient’s immunosuppression regimen was decreased and additional antifungal therapy with voriconazole was presumptively begun.
Which of the following represents an appropriate step for the evaluation of this patient? (Click on the correct answer to proceed to the fifth of eight panels)