A 50-year-old woman presents with a 4-week history of fever, shoness of breath and dry cough. She repos that her chest feels "tight." The patient is a pigeon fancier. Blood tests show leukocytosis and neutrophilia, an elevated erythrocyte sedimentation rate and increased levels of immunoglobulins and C-reactive protein. A lung biopsy reveals poorly formed granulomas composed of epithelioid macrophages and multinucleated giant cells. Which of the following is the appropriate diagnosis?
Actinomycosis Goodpasture syndrome Hypersensitivity pneumonitis Wegener granulomatosis