prasannakumar
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A 26-year-old man comes with his girlfriend to the emergency department due to a very high fever. He just finished his second cycle of BEP (bleomycin, etoposide, cisplatin) chemotherapy for metastatic seminoma 4 days ago. Other than his fever, he has no complaints. He denies any chest pain, cough, diarrhea or any rash. He stopped smoking ever since he was diagnosed with his "deadly disease," but drinks alcohol occasionally. His temperature is 38.9 C (102 F), blood pressure is 118/70 mm Hg, pulse is 102/min, and respirations are 19/min. Physical examination reveals a pale man without any eyebrows or eyelashes. Chest auscultation is clear. Blood tests reveal: What is the best next step in the management of this patient? WBC 690/mm3 with 9% neutrophils Hemoglobin 8.6 g/dL Hematocrit 25% Platelets 74,000/mm3
A) Give acetaminophen and send him home
B) Obtain blood cultures and give cefepime
C) Obtain blood cultures and give vancomycin
D) Order blood cultures and wait for the results
E) Give blood, platelet, and G-CSF transfusion
F) Give gentamicin and metronidazole
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| ssrpk
Forum Fanatic
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B) Obtain blood cultures and give cefepime
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| rockingdoctor
Forum Elite
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B (febrile neuropenia)
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| cirus
Forum Guru
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Yes b
can someone explain the diiferent circumstances of fever with Chemotherapy & how it is managed
I'm confused with this part
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| khorshid
Forum Guru
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B (this is emergency)
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| doyoudig
Forum Guru
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Yes take BLood Cultures 1st, then give Ab hwile waiting for results of Culture
= Febrile Neutropenia
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| young_doc
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If doesn't improve after 3 days or so...consider starting anti-fungals.
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| dr in trouble
Forum Guru
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what is the most common organism associated with neutropenic fever???? Pseudomonas---??
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| ssrpk
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i don't know about most common but pseudomonas is very common
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