A patient with a previous history of tuberculosis now complains of hemoptysis. Chest x-ray reveals an upper lobe mass with a cavity and a crescent-shaped air-fluid level. Select the most likely etiologic agent.: (A) Aspergillus flavus, (B) Coccidioides immitis, (C) Herpes simplex virus type 1, (D) Herpes simplex virus type 2
Answer is A. The patient who has a history of tuberculosis and now complains of haemoptysis would be revaluated for active tuberculosis. However, the chest x-ray described is characteristic of a fungus ball--almost always the result of an aspergilloma growing in a previous cavitary lesion.