A Suspicious Tropical Cough

🗒️ Question 

A 25 year old woman presents to the clinic with a 3 week history of persistent cough, night sweats and unintentional weight loss. She has no significant past medical history but mentions she recently returned from a trip from central Africa.

On examination, she has a low-grade fever and crackles in the right upper lobe of her lung. A chest X-ray reveals a small cavitary lesion in the right upper lobe.

Which of the following is the most appropriate next step in the management of this patient?

(A) Broad spectrum antibiotics
(B) Acid-fast bacillus smear and culture
(C) Oral corticosteroids
(D) Lung lobectomy
(E) Bed rest and increased fluid intake