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A 26-year-old man with testicular cancer who is receiving chemotherapy is evaluated in the emergency department. His temperature is 38.9 °C (102 °F), and he complains of feeling flushed and tired. He has an indwelling central venous port, but there are no localizing symptoms to suggest a source of infection. Chest radiograph shows no abnormalities. The patients hemoglobin is 8.9 gIdL; the absolute neutrophil count is 165/μL and the platelet count is 56,000/μL. Results of other laboratory studies and urinalysis are within normal limits. Blood samples are obtained from a peripheral vein and through the port and sent for culture; a urine culture is also ordered. The patient is hospitalized and intravenous ceftazidime is initiated. Three days later, the patient‟s temperature is 37.8 °C (100 °F) and absolute neutrophil count is 4504/μL; his clinical condition is otherwise stable. Results of blood and urine cultures are negative. A repeat chest radiograph is normal, and blood and urine speci |
A. | Continue the current antibiotic regimen |
B. | Add vancomycin |
C. | Switch to oral ciprofloxacin and amoxicillin-clavulanic acid |
D. | Add granulocyte colony-stimulating factor |
E. | Remove the central venous port |
Answer» A. Continue the current antibiotic regimen |
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