A 27-year-old woman comes to the physician because of a 2-mo…
A 27-year-old woman comes to the physician because of a 2-month history of increasing shortness of breath and a nonproductive cough. She has been unable to perform her daily activities. She has also had malaise and bilateral ankle pain during this period. She is a research assistant at the university’s geology laboratory. She was born in Nigeria and visits her family there twice a year; her last trip was 3 months ago. Her temperature is 37.8°C (100.0°F), pulse is 100/min, respirations are 24/min, and blood pressure is 112/72 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%. There is no palpable cervical or axillary lymphadenopathy. The lungs are clear to auscultation. Examination shows ciliary injection and photophobia of the left eye. The remainder of the examination shows no abnormalities. A complete blood count is within the reference range. An x-ray of the chest is shown below. Which of the following is the most likely diagnosis?
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