Q. A 54-year-old male presents to your clinic for follow-up after being treated for community-acquired pneumonia three weeks ago. He reports completing the entire course of doxycycline you prescribed, as well as resolution of his initial presenting symptoms of fever, headache, nonproductive cough, and chest pain. Today, the patient reports “just not feeling myself”, and describes chronic fatigue and unintentional weight loss. He also reports new onset of “blind spots” in his vision, and states that “colors just don’t appear right”. You review his medical record and note the patient had a normal dilated eye examination six months ago. His past medical history is significant for hypertension, hyperlipidemia, diabetes, and seasonal allergies. The patient is a farmer and raises cows and chickens. He does not smoke tobacco, and has no history of regular alcohol consumption. On physical examination, he is afebrile and in no acute distress. His blood pressure is 140/90 mm Hg, heart rate 75/min, respiratory rate 18/min, and oxygen saturation is 99 percent on room air. His pupils are equal, round, and reactive to light. Visual acuity is noted to be 20/20 in his right eye, and 20/40 in his left eye. Fundoscopic evaluation of his right eye in normal. In his left eye, you detect multiple, small, round, yellow-white lesions surrounding the macula with a moth-eaten appearance (see image), and a moderate amount of associated optic disc edema. His cardiac exam is unremarkable. Chest auscultation reveals diffuse crackles and an apparent focal consolidation in the right upper lobe. You order a chest x-ray, which demonstrates diffuse, patchy infiltrates predominantly in the upper lobes, as well as numerous small, cavitary lesions in the right upper lobe with notable mediastinal lymphadenopathy. Based on the information you have at this point in time, which of the following is the best choice of pharmacologic therapy for this patient?