Case 161 Enunciado A 39-year-old male patient has a history of a 3-month intense and diffuse abdominal pain. Two months ago, developed a progressive dyspnoea at rest, associated with a feeling of increased body temperature (not measured), chills, vomiting, sweating and morning coughing. There was a concomitant weight loss of 22 kg. There are reports of exposure to pesticides for five months without use of personal protective equipment. On examination, he was emaciated, dyspnoeic and sweaty, breath sounds were diminished at both hemithoraces bases, and respiratory rate was 2 breaths per minute, on supplemental oxygen by face mask. Rapid test for identification of antibodies to human immunodeficiency virus (HIV) was positive. CT of the chest, 5.00 mm thickness sections, without intravenous injection of iodinated contrast, supracarinal level: opacification of the upper lung lobes, standard ground-glass attenuation. CT of the chest, 5.00 mm thickness sections, without intravenous injection of iodinated contrast, infracarinal level: opacification of the lower lung lobes, standard ground-glass attenuation. Question:Considering images provided and clinical history, which is the most likely diagnosis? Bacterial Pneumonia Pneumocystis pulmonary infection Hypersensitivity Pneumonitis Pulmonary Tuberculosis Time is Up! Time's up
