A 35-year-old woman presents at clinic with fever, productive cough, diarrhea, headache, anorexia, sore throat and dysphagia.

A 35-year-old woman presents at clinic with fever, productive cough, diarrhea, headache, anorexia, sore throat and dysphagia. She notes a ten-pound weight loss since her last visit 3 months ago. She has had unprotected sexual intercourse with more than one partner over the course of the past year. On physical exam crackles were heard at her lung bases with the stethoscope. Her oxygen saturation was 77 mm Hg while breathing room air. Chest Xray showed diffuse interstitial infiltrates. Her white blood cell count was low. She was referred to a pulmonary specialist for bronchoscopy. On bronchiolar lavage (BAL) the fungus shown below was detected. Sporothorix schenckii Trichophyton rubrum Pneumocystis jirovecii Rhizopus oryzae Pneumococcal pneumoniae

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