welcome redditors!to snoo-finity ... and beyond!

NBME 20 Answers

nbme20/Block 3/Question#35

A 51-year-old man has the acute onset of fever and ...

Cytomegalovirus infection

Login to comment/vote.

 +16  upvote downvote
submitted by amorah(31),

Fever -> rule out left ventricular failure TMP-SMX prophylaxis -> rule out Pneumocystis jiroveci Kidney transplant but no WBC/RBC in urine -> rule out transplant rejection

Leaving CMV and atypical mycobacterium as the remaining two options. CMV is more likely in a transplant patient.

 +2  upvote downvote
submitted by hayayah(447),

CMV is associated with infecting organ transplant patients. CMV is transmitted via sexual contact, organ transplant, or vertically via placenta. Reactivation of CMV occurs in the immunosuppressed.

Organ transplant patients are at an increased risk of CMV pneumonia.