Review Question - QID 210885

A 60-year-old man presents to the emergency department with shortness of breath, cough, and fever. He states that his symptoms started a few days ago and have been progressively worsening. The patient recently returned from international travel. He works from home and manages a chicken coop as a hobby. He has a past medical history of an ST-elevation myocardial infarction and recently has had multiple sick contacts. His temperature is 102°F (38.9°C), blood pressure is 187/108 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 93% on room air. A radiograph of the chest reveals bilateral pleural effusions. Pleurocentesis demonstrates the findings below:

Protein ratio (pleural/serum): 0.8
Lactate dehydrogenase ratio (pleural/serum): 0.75
Glucose: 52 mg/dL

Further analysis reveals a lymphocytic leukocytosis of the pleural fluid. Which of the following is the most appropriate next step in management?