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Pathology
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?
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
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