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137452 Medicine

A 44-year-old man with a prior renal transplant presents to the clinic for evaluation of symptoms consisting of a cough and shortness of breath on exertion. There is no sputum production and he has no prior respiratory or cardiac illnesses. On physical examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse perihilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver. Which of the following is the most appropriate next step in management?

Aamphotericin B
Bcephalosporins
Ctrimethoprim-sulfamethoxazole
Daminoglycosides
Medicine
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