59) A 62-year-old male on total parenteral nutrition (TPN) for | Surgery videos & books

59) A 62-year-old male on total parenteral nutrition (TPN) for 2 weeks following development of a postoperative enterocutaneous fistula has developed high, spiking temperatures up to 102.2°F over the last 8 hours. The only abnormal finding on physical examination is erythema and induration around his central line. The most appropriate management is which of the following?
(A) begin broad-spectrum antibiotics and observe for 24 hours
(B) obtain blood cultures through the central line, begin broad-spectrum antibiotics and await culture results
(C) remove catheter, send tip for culture and replace with a new central line over the guide wire
(D) remove catheter, send tip for culture and establish central line at another site
(E) remove catheter, send for culture and establish peripheral intravenous line