21st June 2024

A 63-year-old patient is referred from the acute medical unit with a 2-week history of productive cough

A 63-year-old patient is referred from the acute medical unit with a 2-week history of productive cough, night sweats and haemoptysis. Their plain film chest shows patchy opacification on the upper right and mid-zone lung with fibrotic shadows, as well as bilateral hilar lymphadenopathy. They have spent much of their adult life in prison and have no other relevant past medical history. The referring doctor was initially concerned about tuberculosis; however, an interferon-gamma-release assay has given a negative result. What is the next best course of action?

Select the SINGLE most appropriate option from the list below. Select ONE option only.