A 45-year-old man presents with a 4-week history of unintentional 6 kg weight loss, intermittent fevers, and intense bilateral calf pain. Yesterday, he noticed weakness in his right foot, causing him to trip repeatedly. He also reports a 3-day history of severe right testicular pain. He has no history of asthma, chronic sinusitis, or recreational drug use. He takes no daily medications.

He appears ill and in moderate distress due to leg pain. He is febrile to 38.5°C. His blood pressure is 160/100 mmHg with a heart rate of 105 bpm and a respiratory rate of 16 breaths per minute.