Medical history Male patient, 49 years old, a farmer from the eastern region of Minas Gerais, smoker and alcoholic, presenting a productive cough without hemoptysis or hemoptysis, a discreet increase in body temperature, chills, headache, malaise, inappetence and painful cervicoaxillary lymphadenopathy in the last six months. Simple chest radiographs were performed and empirical treatment for pulmonary tuberculosis was started. He returned to the outpatient clinic after two months with worsening of the symptomatology, and it was made drainage of milky discharge from the cervical nodes. He denied similar symptomatology in relatives. Image 1: Chest radiograph, posteroanterior view, orthostatic position.Image 2: Chest radiograph, lateral view, orthostatic position. Question Considering the clinical history and the presented images, which one is the most likely diagnosis? Post-primary pulmonary tuberculosis Pulmonary toxoplasmosis Paracoccidioidomycosis Wegener's granulomatosis Test question Questão de prova: (Medical residency - 2014 - Unified Selection Process – MG): The finding of the microorganisms shown below (staining by silver methenamine) in a patient with lymphadenopathy and cutaneous mucosal ulcer lesions allows the diagnosis of: Chromomycosis Cutaneous mucosal leishmaniasis Virchowian leprosy Paracoccidioidomycosis Time is Up! Time's up
