medicine ? -

[ArchivalUser]

bizzy

A 19-year-old man with acute nonlymphocytic leukemia is admitted to the hospital 2 weeks after his first round of chemotherapy. His temperature is 39.2 C, and physical examination shows no localized abnormalities. Chest radiograph shows a Hickman catheter with its tip in the right atrium. The white blood count (WBC) is 300/m^3 with no polymorphonuclear or band cells in the differential count. Blood cultures were obtained. Which of the following is the next step?

(A) Initiate antistaphylococcal treatment for the possibility of Hickman catheyer-related bacteria
(B) Administer broad-spectrum antibiotics with excellent activity for enteric gram negative rods and Pseudomonas aeruginosa
© Await results of blood cultures and other diagnostic tests because infection could be caused by almost any microorganism
(D) Administer parenteral antifungal therapy

Please explain answers

[ArchivalUser]

Mer

D ? : immunosuppressed pt on chemotherapy with indwelling catheter... candidemia likely . iv Amph B or Fluconazole DOC.

[ArchivalUser]

Matthew

B

[ArchivalUser]

Sunny

Is it B?

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bizzy

Anyone else?

[ArchivalUser]

dharm

IT SEEMS TO BE " B"

[ArchivalUser]

bizzy

B is the correct answer. Broad-spectrum antibiotics with activity against enteric gram negative rods and Pseudomonas aeruginosa. The heightened susceptibility of neutropenic patients to die quickly from overwhelming sepsis makes early diagnosis obligatory. Even though many clinicians include antibiotic coverage for staph, the MOST COMMON bacteria encountered are gram-negative rods. Antifungal treatment is used if antibacterial therapy fails to control the fever or if a specific fungal infection is found. Prophylaxis is started before having evidence of active infection.