Parent of a 1 year-old female on home parenteral nutrition secondary to short bowel syndrome (necrotizing enterocolitis) calls with a 2-day history of fever 101 degrees Fahrenheit (38.3 degrees Celsius). There are no other clinical complaints besides from teething.
What is the next step?
A. Prescribe acetaminophen or another over-the-counter anti-pyretic. If fever persists for another 2-3 hours, tell family to call back.
B. Check complete blood count (CBC) as outpatient. If white blood count elevated, consider further work-up.
C. Refer to the local emergency department for bacteremia work-up.
D. Offer parent reassurance and monitor clinically off antibiotics.
E. Order oral antibiotics to local pharmacy for possible viral infection.