Case 10

Max has fungal pneumonia-an unexpected diagnosis. However, respiratory histoplasmosis has been reported in strictly indoor cats in nonendemic areas. How these cats acquire the infection is not known definitively, but access to soil from houseplants is commonly thought to be a possible culprit. Also, if there is a lot of dust in the house because of recent construction or remodeling, this may be a source. Chances are we will never know for sure.

QUESTION 3

What would have been your best next step for Max if the cytology results had been nondiagnostic?

a) A transtracheal wash

b) Referral for bronchoscopy and bronchoalveolar lavage

c) Continue clindamycin and monitor for response to treatment

d) Toxoplasmosis titer

e) Start prednisone for suspected lymphoma

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