Approach to splenic masses Quiz: Ace Your Exams
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A 41-year-old man presents to the emergency department for evaluation of two days of fever, with a maximum temperature at home of 39.1ºC (102.4ºF). The patient has been short of breath for the past day. There is no significant past medical history, and the patient takes no medications. Temperature is 38.6ºC (101.5ºF), pulse is 112/min, respiratory rate is 16/min, blood pressure is 118/72 mmHg, and oxygen saturation is 97% on room air. Physical examination reveals track marks on the bilateral upper extremities. Several fingers have a small, dark, straight line through the fingertip nail. There are painless lesions over the bilateral soles of the feet. A systolic murmur is heard on cardiac auscultation. There is mild tenderness to palpation in the left upper quadrant. Computed tomography (CT) imaging of the abdomen shows a hypodense round fluid collection with rim enhancement and an air-fluid level. Which of the following is the best next step in management?
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