robin082006
Forum Hero
Topics: 471
Posts: 5,123
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Mr. Glenn, a 26-year-old man, comes with his girlfriend to ER with a very high fever. He finished his second cycle of BEP (bleomycin, etoposide, and cisplatin) chemotherapy for metastatic seminoma 4 days ago. Other than his fever, the patient has no complaints. He denies any chest pain, cough, diarrhea or any rash. He has stopped smoking since he was diagnosed with the "deadly disease", but drinks alcohol "off and on". His Temperature: 38.9C[102F); BP: 118/70 mm Hg; PR: 102/min; RR: 19/min. On examination he appears pale. He is wearing a wig and does not have eyebrows or eyelashes. Blood tests were ordered and the results are
WBC 690/mm3 with 9% neutrophils
Hemoglobin 8.6
Hematocrit 25%,
Platelets 74,000/mm3
What is the next best step in the management of this patient?
A. Give acetaminophen
B. Admit the patient; obtain blood cultures and give IV cefepime
C. Admit the patient; obtain blood cultures and give vancomycin
D. Order blood cultures and then decide treatment according to the results
E. Give blood, platelet, and G-CSF transfusion
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| Data297
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B?
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| ed222
Forum Senior
Topics: 4
Posts: 147
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B due to his condition a broad spectrum antibiotic
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| bangledoc
Forum Senior
Topics: 10
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D
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| drashishmahajan
Forum Senior
Topics: 6
Posts: 92
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cefepime is abroad spectrum antibiotic tht r usually given in the netropenic patient.. u cannt wait for the culture results to km . blood transfusion n GCSF r given but tht is for the long term purpose to raise the counts on ly after 1st admiting the patient n covering the patient under the 1st dose of the antibiiotics
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