31st January 2024

A 30-year-old with no fixed abode is seen in the emergency department with thoracic back pain.

A 30-year-old with no fixed abode is seen in the emergency department with thoracic back pain. He reports widespread pain throughout his body and un-refreshing sleep. He seems vague and forgetful but has mentioned a cough. He is an ex-intravenous drug user and takes methadone. Observations show heart rate 95, saturations 96%, respiratory rate 18, blood pressure 108/66 and temperature 38.0. On examination, he has tenderness over his thoracic spine, and you notice scabs in his groin. His Chest x-ray is normal.

Which of the following is the most appropriate next step?

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