<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 44-year-old man comes to the physician because of a 3-week history of productive cough, fever, and lethargy. He also has several skin lesions over his body. His symptoms began 3 weeks after he returned from a camping trip in Kentucky. Three years ago, he underwent kidney transplantation for polycystic kidney disease. Current medications include sirolimus and prednisone. His temperature is 38C 100.4F. Diffuse crackles are heard over the lung fields. There are 4 white, verrucous skin patches over his chest and upper limbs. A photomicrograph of a skin biopsy specimen from one of the lesions is shown. Which of the following is the most likely diagnosis?? A: Histoplasmosis, B: Mucormycosis, C: Coccidioidomycosis, D: Cryptococcosis, E: Blastomycosis,  <response>: This is a patient with symptoms of productive cough, fever, and lethargy after returning from a camping trip in Kentucky. He has a history of kidney transplantation and is on immunosuppressive medications sirolimus and prednisone. On exam he has fever, crackles on lung exam, and skin lesions. A skin biopsy shows yeast forms consistent with fungal infection. The key clues are the exposure history in Kentucky, the immunosuppressed state, and the skin biopsy findings. Kentucky is an endemic region for blastomycosis and histoplasmosis. Immunosuppression predisposes to opportunistic fungal infections. The skin biopsy shows broad-based budding yeast, most consistent with blastomycosis.Therefore, the most likely diagnosis is blastomycosis.E: Blastomycosis 