A 26-Year-Old Man Undergoing Chemotherapy for Metastatic Seminoma Comes to the Emergency

A 26-year-old man undergoing chemotherapy for metastatic seminoma comes to the emergency department with fever and chills for the last 24 hours.  He has no chest pain, shortness of breath, cough, abdominal pain, diarrhea, or skin rash.  His temperature is 38.9 C (102 F) , blood pressure is 118/70 mm Hg, pulse is 102/min, and respirations are 18/min.  Examination shows mucosal pallor.  There is mild gingival erythema but no evidence of bleeding.  The cardiopulmonary examination is normal.  The abdomen is soft and nontender to palpation.  The perianal area is without lesions.  Laboratory results are as follows: Chest x-ray shows no infiltrates.  Urinalysis is normal.  The patient is admitted to the hospital.  Which of the following is the most appropriate initial therapy for this patient?

A) Acyclovir
B) Ceftriaxone
C) Ciprofloxacin
D) Linezolid
E) Piperacillin-tazobactam
F) Vancomycin
G) Voriconazole

Correct Answer:

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