A 15-Year-Old Boy with Sickle Cell Disease Is Brought to the Emergency

A 15-year-old boy with sickle cell disease is brought to the emergency department due to 2 days of fever and severe pain in the left knee.  The patient has been hospitalized previously for acute vasoocclusive crises, which generally occur in his arms.  His temperature is 38.2 C (100.8 F) .  Physical examination shows marked tenderness and swelling over the proximal tibia.  Laboratory studies reveal leukocytosis and an elevated C-reactive protein.  MRI of the left leg shows marked inflammation of the proximal tibia without joint effusion.  Blood culture is obtained.  Which of the following is the most appropriate choice of empiric antibiotic therapy?

A) Cefazolin
B) Ceftriaxone and clindamycin
C) Clindamycin and oxacillin
D) Gentamicin
E) Vancomycin

Correct Answer:

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