Soru

A 14-month-old girl is evaluated during morning rounds on hospital day 3. She was initially admitted due to a high fever, irritability, and an inability to bear weight on her right leg. Her medical history is significant for acute lymphoblastic leukemia, and she is currently in the maintenance phase of chemotherapy with daily oral 6-mercaptopurine and weekly oral methotrexate. Upon initial evaluation, her temperature was $39.4^\circ\text{C}$ ($102.9^\circ\text{F}$). Physical examination revealed an exquisitely tender, swollen, and erythematous right knee. Initial laboratory studies showed a leukocyte count of $4,500/\text{mm}^3$ with an absolute neutrophil count of $1,350/\text{mm}^3$. Arthrocentesis yielded visibly purulent synovial fluid, and she was promptly started on empiric intravenous vancomycin and cefepime.

Today, her temperature is $37.6^\circ\text{C}$ ($99.7^\circ\text{F}$) and she is clinically improving with decreased knee swelling. Synovial fluid and blood cultures obtained on admission both grow Staphylococcus aureus. Susceptibility testing demonstrates resistance to penicillin and ampicillin, but susceptibility to oxacillin, cefazolin, clindamycin, and vancomycin.

During the evaluation, the parents express concern about a recent local measles outbreak. They note that their daughter missed her 12-month well-child visit due to her cancer treatments and ask if she can receive her measles, mumps, and rubella (MMR) and varicella vaccines before discharge.

Which of the following is the most appropriate management plan regarding her antimicrobial therapy and requested immunizations?