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Acute gout flare in CKD — RCPSC IM MCQ

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HardRheumatologyAcute gout flare in CKDRCPSC IM

A patient with newly diagnosed acute leukemia has fever, ANC 0.1 ×10⁹/L and BP 86/48 mmHg. Blood cultures are being obtained and there is no clear catheter infection. Which antimicrobial principle is correct?

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Correct answer: BStart IV antipseudomonal therapy after cultures are taken

Neutropenic shock requires immediate IV antipseudomonal antibiotics; cultures should not cause meaningful delay. Routine line removal, oral treatment, vancomycin alone, or CT before antimicrobials are unsafe in this high-risk syndrome.

Reference: Cancer Care Ontario, Prevention and Outpatient Management of Febrile Neutropenia in Adult Cancer Patients: https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38561