A 26-year-old man with testicular cancer who is receiving chemotherapy is evaluated in the emergency department. His temperature is 38.9 C (102 F), and he complains of feeling flushed and tired. He has an indwelling central venous port, but there are no localizing symptoms to suggest a source of infection. Chest radiograph shows no abnormalities. The patients hemoglobin is 8.9 gIdL; the absolute neutrophil count is 165/ L and the platelet count is 56,000/ L. Results of other laboratory studies and urinalysis are within normal limits. Blood samples are obtained from a peripheral vein and through the port and sent for culture; a urine culture is also ordered. The patient is hospitalized and intravenous ceftazidime is initiated. Three days later, the patient s temperature is 37.8 C (100 F) and absolute neutrophil count is 4504/ L; his clinical condition is otherwise stable. Results of blood and urine cultures are negative. A repeat chest radiograph is normal, and blood and urine speci

• A. Continue the current antibiotic regimen
• B. Add vancomycin
• C. Switch to oral ciprofloxacin and amoxicillin-clavulanic acid
• D. Add granulocyte colony-stimulating factor
• E. Remove the central venous port