Correct!
5. All of the above

It is unclear what is the cause of the patient's cough, dyspnea and hypoxemia. Valley fever is certainly possible and a sputum culture with empiric antibiotics is reasonable. The thoracic CT scan from a month prior to admission is normal and a repeat CT scan seems justified (Figure 2).

Figure 2. Repeat thoracic CT scan in lung windows.

What is the next most appropriate step? (Click on the correct answer to proceed to the next panel)

1. Begin amphotericin
   
2. Begin fluconazole
   
3. Bronchoscopy with bronchoalveolar lavage
   
4. Switch the antibiotics to an aminoglycoside and methicillin
   
5. Video-assisted thorascopic surgery (VATS)

Home/Pulmonary