Correct!
4. 1 and 3

He has not responded well to therapy and consideration should be given to an etiology of a pneumonia caused by an organism other than Streptococcus pneumoniae. In Arizona Valley fever or coccidioidomycosis (cocci) causes an estimated 15% to nearly 30% of community-acquired pneumonias (3). After 1 week (10/27) a bronchoscopy with bronchoalveolar lavage (BAL) was performed. The results of the BAL are given below:

• BAL: 39% alveolar macrophages, 34% lymphocytes, 25% polymorphonuclear leukocytes, 2% eosinophils
• Gram stain, fungal smear and acid-fast bacteria smears negative

What treatment should he receive at this time? (Click on the correct answer to be directed to the sixth of seven pages)

1. Fluconazole
2. Itraconazole
3. Ketoconazole
4. Posaconazole
5. Voriconazole

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