<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 33-year-old man presents to the emergency department with back pain. He is currently intoxicated but states that he is having severe back pain and is requesting morphine and lorazepam. The patient has a past medical history of alcohol abuse, drug seeking behavior, and IV drug abuse and does not routinely see a physician. His temperature is 102F 38.9C, blood pressure is 12768 mmHg, pulse is 120min, respirations are 17min, and oxygen saturation is 98 on room air. Physical exam is notable for tenderness over the thoracic and lumbar spine. The pain is exacerbated with flexion of the spine. The patients laboratory values are notable for the findings below.Hemoglobin: 12 gdLHematocrit: 36Leukocyte count: 16,500mm3 with normal differentialPlatelet count: 197,000mm3Serum:Na: 139 mEqLCl-: 100 mEqLK: 4.3 mEqLHCO3-: 25 mEqLBUN: 20 mgdLGlucose: 99 mgdLCreatinine: 1.1 mgdLCa2: 10.2 mgdLCRP: 5.2 mgLFurther imaging is currently pending. Which of the following is the most likely diagnosis?? A: Herniated nucleus pulposus, B: Malingering, C: Musculoskeletal strain, D: Spinal epidural abscess, E: Spinal epidural hematoma,  <response>: This is a clinical case scenario involving a 33-year-old man with back pain and fever. The key findings are:- Back pain, worse with flexion- Fever of 102F - Elevated white blood cell count of 16,500- Elevated CRP of 5.2 mgL- History of IV drug useThe differential diagnosis includes:- Herniated nucleus pulposus - Unlikely given fever and elevated inflammatory markers- Malingering - Possible given history of drug seeking behavior- Musculoskeletal strain - Unlikely given fever - Spinal epidural abscess - Most likely given fever, back pain worse with flexion, elevated WBC and CRP in an IV drug user- Spinal epidural hematoma - Unlikely given normal platelet count and no trauma historyD: Spinal epidural abscess 