Correct!
4. All of the above
Pulmonary contusion is possible but very unlikely given his history and lack of trauma elsewhere. Sputum cultures were obtained at admission. HIV testing, coccidiomycosis serology and Trypanosoma cruzi serology (Chagas disease) were all negative.
He was begun on antibiotics for suspected aspiration pneumonia from his achalasia. After a few days in the hospital he signed out against medical advice (AMA).
Shortly after the patient left, the laboratory called saying that his initial sputum culture was growing acid-fast bacilli (AFB).
Which of the following would be most likely to explain his positive AFB culture?