A 28-year-old man from Arizona presents to the emergency department with a 3-week history of persistent cough, fever, and bilateral ankle swelling. He reports recent construction work at a new housing development. Vital signs: BP 128/82, HR 92, RR 18, Temperature 38.2°C, SpO2 98% on room air. Physical examination reveals erythema nodosum on bilateral shins. Chest X-ray shows bilateral hilar lymphadenopathy with right upper lobe nodules and a small thin-walled cavity. Serum IgM antibodies to Coccidioides immitis are positive. Comprehensive metabolic panel and complete blood count are within normal limits. Which of the following is the most appropriate next step in management?

1. A)Initiate oral fluconazole and arrange close outpatient follow-up with repeat imaging in 4-6 weeksGABARITO
2. B)Admit to the hospital and start intravenous amphotericin B deoxycholate immediately
3. C)Start a standard 4-drug antituberculous regimen pending TB culture results
4. D)Observe without antifungal therapy; coccidioidal pneumonia is self-limited in immunocompetent hosts
5. E)Perform urgent surgical resection of the cavitary lesion to prevent hemorrhage and dissemination