27th May 2025

An 86-year-old male presents with lethargy, fever and a significantly swollen left knee.

An 86-year-old male presents with lethargy, fever and a significantly swollen left knee. He has a past medical history of gout in the left knee, chronic kidney disease and atrial fibrillation, for which he is anticoagulated with warfarin. 

His blood results are as follows:

Haemoglobin 99 g/L

White Cell Count 15.7 x10⁹/L

Neutrophils 11.6 x10⁹/L

Platelets 567 x10⁹/L

INR 3

Creatinine 456 µmol/L

What is the next most appropriate course of action?

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