1) An otherwise healthy
65-year-old woman presents with persistent shortness of breath and cough. She
reports that during the past 6 months, she has had recurrent bouts of pneumonia;
she had migrating opacities on chest radiograph that have been treated with
multiple courses of oral antibiotics. She has had intermittent fever and cough,
but she has had no sick contacts, sputum production, or hemoptysis. A thorough
exposure history is unrevealing. A CT scan shows areas of consolidation.
Surgical lung biopsy shows no evidence of infection or malignancy but reveals
patchy alveolar filling with loose plugs of granulation tissue. Which one of
the following is an appropriate initial therapeutic option for this patient? *
