A 55-year-old woman who does not smoke has a 3-month history of dyspnea on exertion, weight loss,…

A 55-year-old woman who does not smoke has a 3-month history
of dyspnea on exertion, weight loss, and cough productive of copious amounts of
clear, frothy sputum. She has no fever or chills. She has been treated for 2
weeks for “double pneumonia” without relief of the symptoms. Examination
reveals finger clubbing and decreased air entry in both lung bases with
dullness to percussion. A chest radiograph shows bilateral alveolar
infiltrates. What should be done next?

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