Which of the following are NOT typical signs and symptoms of pericarditis? (Select-all-that-apply)
(Select All that Apply.)

A. Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism: In older adults, the immune response may be slower or less effective due to age-related changes in the immune system. The virulence of Histoplasma capsulatum can also contribute to the severity of the infection, making it more difficult for the immune system to mount an effective response quickly, which explains the symptoms of fever, nausea, and vomiting.

B. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them: While macrophages play a crucial role in the immune response to fungi, in the case of histoplasmosis, they often engulf the fungi but may struggle to completely eradicate them, especially in immunocompromised individuals or the elderly. However, this option does not fully explain the delayed symptoms associated with the patient's age and the organism's virulence.

C. Spore inhalation initiates an autoimmune response that produces the associated symptoms: Histoplasmosis is caused by inhaling spores of Histoplasma capsulatum, but the symptoms are not the result of an autoimmune response. Instead, the immune system's attempt to combat the infection leads to the clinical manifestations, not an autoimmune process.

D. Toxin production by Histoplasma capsulatum is triggering an immune response: Histoplasma capsulatum does not produce toxins that directly trigger an immune response. Instead, the immune response is primarily due to the presence of the fungi themselves and the inflammatory response they provoke, which leads to the associated symptoms of the infection.

A. Fever: Fever is a common sign of pericarditis, often indicating inflammation or infection in the pericardial sac. This symptom is typical in patients with this condition.

B. Mild chest pain: Mild chest pain is a typical symptom of pericarditis. Patients often experience sharp, pleuritic chest pain that may worsen with inspiration or coughing.

C. No evidence of fatigue: Fatigue can be a common symptom in patients with pericarditis due to the body's response to inflammation. Therefore, the absence of fatigue is not typical, making this an appropriate choice.

D. Myalgias: Myalgias or muscle aches can occur in pericarditis as part of the systemic inflammatory response. This symptom is not unusual in patients with this condition.

E. Pericardial friction rub: A pericardial friction rub is a characteristic finding in pericarditis, heard during auscultation. It results from the movement of inflamed pericardial layers against each other.

F. Radiating substernal pain felt in the left shoulder: This type of radiating pain is more characteristic of myocardial ischemia or angina rather than pericarditis. While pericarditis can cause chest pain, it does not typically radiate in the same manner as that seen in cardiac conditions, making this an appropriate choice.