28th May 2025

A 67-year-old lady has attended the emergency department with fevers, chills and sweats.

A 67-year-old lady has attended the emergency department with fevers, chills and sweats. Her past medical history includes a 23mm ER +ve/HER2 -ve breast cancer for which she underwent a wide local excision and axillary nodal clearance (4/11 nodes positive). She is currently receiving adjuvant Epirubicin and Cyclophosphamide chemotherapy, her last cycle was delivered 5 days ago. Observations are: HR 94, BP 112/54, RR 20, Sats 96% on room air, T 39.4℃.

What is the most important next step in the management of this patient?