Febrile neutropenia Quiz: Ace Your Exams

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A 67-year-old woman presents to the emergency department for evaluation of malaise. The patient reports increasing fatigue, anorexia, and chills over the past two days. The patient is currently being treated for HER-2 positive breast cancer and last received chemotherapy four days ago. Temperature is 39.0 °C (102.2 °F), pulse is 110/min, respiratory rate is 22/min, blood pressure is 95/60 mmHg, and oxygen saturation is 98% on room air. On physical examination, the patient appears fatigued and has dry mucous membranes. There is a port over the right chest wall with no erythema or purulence. The rest of the physical examination is within normal limits. The patient is given intravenous fluids and acetaminophen. Laboratory studies show an absolute neutrophil count of 200 cells/µL (2400-6800 cells/µL). Blood cultures are pending. Which of the following is the best next step in management?  

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