A 58-year-old homeless man who is HIV positive presents to you with altered mental status. He has lost 30 pounds in only a few months, has had fever, poor appetite, and progressive weakness. A chart review shows that he also presented two days ago and that he has a nonproductive cough. His vital signs are as follows: BP 96/70 mm Hg, HR 110 beats/minute, RR 18 breaths/minute, temperature 100.2°F (37.9°C), and 95% oxygen saturation on room air. He is disheveled, awake, responsive, and disoriented. The lungs sound clear, and the abdominal examination is benign. Laboratory results show an elevated transaminase level, a sodium level of 126, and a white cell count of 12.8. A purified protein derivative (PPD) test placed two days earlier during a previous visit is positive at 16-mm induration. The chest x-ray is shown below.
Which of the following statements is true regarding this patient's condition?
a) Pan cultures usually have a low yield.
b) The low sodium level is due to syndrome of inappropriate antidiuretic hormone secretion (SIADH), which is a rare complication of this illness.
c) Mortality rates for this form of Mycobacterium tuberculosis (MTB) infection are higher than other forms.
d) Treatment should be initiated once culture results confirm the diagnosis.
e) Steroids are of little value if the patient develops respiratory distress syndrome.