Correct!
2. Bronchoscopy with bronchoalveolar lavage

The patient has an undiagnosed diffuse lung process. Bronchoscopy with bronchoalveolar lavage would probably have the best risk-benefit ratio. The patient has had an ongoing process for several weeks and observation in hopes that the process will resolve seems unlikely. Needle aspiration and video-assisted thorascopic (VATS) lung biopsy may also reveal a diagnosis but are more invasive and have higher complication rates than bronchoscopy. 18FFDG-PET scanning is most useful for staging lung cancer.

Bronchoscopy revealed no bronchial abnormalities and the bronchoalveolar lavage stains and smears were negative. However, the cultures grew Cryptococcus neoformans.

Which of the following is true regarding a positive culture for Cryptococcus from the bronchoalveolar lavage fluid?

1. Cryptococcus pneumonia is usually seen in immunocompromised hosts
2. Cryptococcus is a frequent contaminant of bronchoalveolar lavage fluid
3. Cryptococcus should prompt an investigation for possible meningitis/encephalitis
4. 1 and 3
5. All of the above

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