15th July 2024

A 59-year-old man with a known history of granulomatosis with polyangiitis (GPA)

A 59-year-old man with a known history of granulomatosis with polyangiitis (GPA) presents increasingly short of breath.  He has recorded his temperature on his home thermometer to be 38 degrees Celsius on three occasions in the past 24 hours.  He does not admit to any other symptoms when questioned. His regular medications include Lansoprazole 30mg OD, Prednisolone 7.5mg OD and Azathioprine 150 mg BD. On examination, he is tachycardic with a regular pulse of 125, hypotensive at 102/68 mmHg and there are coarse crackles throughout both lung fields. Oxygen saturations are 92% on air and chest x-ray shows bilateral pulmonary infiltrates.

Which is the best of the management strategies listed below?

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