Central line-associated bloodstream infection Quiz: Ace Your Exams

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A 54-year-old-woman is brought to the emergency department due to fever and altered mental status, which started a few hours ago. The patient has breast cancer that was treated with surgical resection, and is currently receiving chemotherapy via an internal jugular venous catheter. The patient’s last chemotherapy was given two weeks ago, and the catheter was removed yesterday. Review of systems is otherwise negative. Temperature is 39.4°C (102.9°F), pulse is 120/min, blood pressure is 87/57 mmHg, respiratory rate is 16/min, and oxygen saturation is 98% on room air. There is no neck stiffness and the rest of the physical examination is unremarkable other than the presence of confusion. Laboratory evaluation shows leukocytosis and elevated C-reactive protein and lactic acid. Which of the following is necessary to establish the diagnosis in this patient?  

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