A 54-year-old man was brought to the hospital emergency room by deportation officers because he reported severe chest pain and abdominal pain that came suddenly. On further questioning, he has had difficulty eating for the last few weeks; his voice became hoarse; his cough became brassy and his back is hurting a lot. Review of systems is significant for shortness of breath and edema in both feet. He is a migrant from Kenya and his past medical history is significant for a painless genital ulcer on his penis and he was treated for chlamydia and gonorrhea. On physical examination, he is pale, sweating profusely, and hypotensive. Oral examination is shown below. Cardiac pulsations are visible. On auscultation, a soft, high-pitched diastolic decrescendo murmur is best heard in the third intercostal space along the left sternal border at end expiration, with the patient sitting and leaning forward. Chest x-ray is shown below. Gross morphology of the aorta showed contraction of intima, irregular scarring of the media and ‘tree barking’ appearance of the intima. Microscopically, obliteration of the vasa vasorum by intimal changes and scarring is noted. The wall of the vessel has a variably dense plasma cell infiltrate. Of the following, which is the recommended treatment for this condition?
