Which of the following conditions does she most likely to have?
A 9-year-old girl has complained of difficulty breathing for the past week. Her vital signs include T 37.9 C, P 80/minute, RR 25/minute, and BP 110/60 mm Hg. On physical examination, her lung fields are clear to auscultation. Her heart rate is regular and no murmurs or gallops are heard. A chest radiograph shows prominent hilar lymphadenopathy along with a 1 cm peripheral right lung nodule in the middle lobe. No infiltrates or masses are present. A sputum gram stain shows normal flora and routine bacterial culture reveals no pathogens.
A. Hypersensitivity pneumonitis B. Mycobacterium tuberculosis infection C. Bronchial carcinoid tumor D. Infective endocarditis E. Goodpasture syndrome
Mycobacterium tuberculosis infection -(b) correct. this is a description of the typical ghon complex of an initial, or primary, tb infection. the peripheral granuloma does not produce symptoms, but the enlarged lymph nodes may impinge upon airways. most persons with a primary infection, however, are asymptomatic and the infection goes unnoticed.(c) incorrect. a carcinoid tumor could produce focal obstruction with a pneumonia, but pulmonary neoplasms in children are rare. most bronchial carcinoids act in a benign fashion without metastases.