1) A 29-year-old man
presents with a 3-week history of cough, fatigue, night sweats, and
intermittent fevers. He reports no prior medical problems. His temperature is
38.3°C, and his lungs are clear on auscultation. He has a leukocyte count of
8000 per mm³ (normal range, 4500–11,000), a serum creatinine level of 1.6 mg/dL
(0.8–1.3), and a random glucose level of 180 mg/dL (<140). Chest radiograph
reveals a small nodular infiltrate in the apical portion of the right upper
lobe and a calcified hilar lymph node. Which one of the following diagnostic
approaches is most appropriate for this patient?