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Neutropenic fever — RCPSC IM MCQ

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ModerateInfectious DiseasesNeutropenic feverRCPSC IM

A 54-year-old man receiving induction chemotherapy for acute myeloid leukemia presents with fever 38.6°C. Absolute neutrophil count is 0.1 x 10^9/L, blood pressure is 108/64 mm Hg, creatinine is normal, and he has no localising symptoms. Blood cultures are drawn immediately. What is the most appropriate next step?

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Correct answer: E — Administer empiric antipseudomonal beta-lactam therapy within 60 minutes

Fever during profound neutropenia is an emergency requiring prompt empiric broad-spectrum antibacterial therapy with antipseudomonal activity after cultures are obtained. Apparent clinical stability does not remove the need for urgent treatment.

Reference: AMMI Canada antimicrobial stewardship principles; IDSA neutropenic fever guidance