Match each clinical presentation of an opportunistic infection in an immunocompromised patient with the most appropriate first-line targeted pharmacotherapy.
- Progressive exertional dyspnea, dry cough, and bilateral ground-glass opacities on chest CT. Sputum reveals cyst-like structures on silver stain.Trimethoprim-sulfamethoxazole
- Headache, confusion, and right-sided hemiparesis. Brain MRI demonstrates multiple ring-enhancing lesions in the basal ganglia.Sulfadiazine, pyrimethamine, and leucovorin
- Fever, profound weight loss, night sweats, and chronic diarrhea. Blood cultures grow a non-tuberculous mycobacterium.Azithromycin and ethambutol
- Decreased visual acuity and floaters. Fundoscopic examination shows perivascular yellow-white retinal exudates with associated hemorrhage.Valganciclovir
Answer
Pneumocystis jirovecii matches with trimethoprim-sulfamethoxazole; Toxoplasma gondii matches with sulfadiazine, pyrimethamine, and leucovorin; Mycobacterium avium complex matches with azithromycin and ethambutol; Cytomegalovirus retinitis matches with valganciclovir.
The correct pairings accurately match each classic opportunistic clinical syndrome to its evidence-based, definitive antimicrobial therapy according to current infectious disease guidelines.
Step-by-Step Solution
Key Concept
First-line pharmacotherapy for opportunistic infections in immunocompromised patients depends on accurately identifying the pathogen from classic clinical presentations and diagnostic findings.