A 45-year-old homeless male presents with persistent cough, weight loss, and night sweats for several weeks. He also reports coughing up blood occasionally. His medical history is unknown. What are the potential diagnoses, and what are the next steps?
Given this patient's symptoms of a persistent cough, weight loss, night sweats, and hemoptysis, along with his homelessness which is a risk factor, tuberculosis is a strong possibility. Other differentials could include other infectious processes like pneumonia or lung abscess, or malignancies like lung cancer. The next step would be to isolate the patient due to the potential for infectious tuberculosis, then obtain a chest X-ray and sputum samples for acid-fast bacilli smear and culture. He may also need an HIV test, as HIV and TB often co-occur.