<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 78-year-old male presents to the emergency department after passing out. His wife reports that she and the patient were walking their dog when he suddenly lost consciousness. On physical exam, he has a loud crescendo-decrescendo systolic murmur and is subsequently diagnosed with severe aortic stenosis. The patient undergoes open aortic valve replacement and has an uncomplicated postoperative course. His sternal wound drain is pulled for low output on post-operative day three. On post-operative day five, the patient complains of pain during deep inspiration and retrosternal chest pain. His temperature is 101.7F 38.7C, blood pressure is 12581 mmHg, pulse is 104min, and respirations are 18min. On physical exam, the patient is tender to palpation around his sternal wound, and there is erythema around the incision without dehiscence. His chest radiograph shows a widened mediastinum with a small pleural effusion on the left. CT angiography shows stranding in the subcutaneous tissue and a fluid collection below the sternum.Which of the following is the best next step in management?? A: Placement of a left-sided chest tube, B: Surgical repair of esophageal perforation, C: Surgical repair of aortic injury, D: Intravenous antibiotics and observation, E: Intravenous antibiotics and debridement of surgical wound,  <response>: This is a clinical vignette about a 78-year-old male who underwent aortic valve replacement surgery and now presents with fever, chest pain, and wound erythema 5 days after the procedure. The key findings are:- Recent aortic valve replacement surgery- Fever, chest pain, wound erythema and tenderness on exam - Widened mediastinum and pleural effusion on CXR- Fluid collection and stranding below the sternum on CTThis presentation is most consistent with post-sternotomy mediastinitis, an infection of the mediastinal space after cardiac surgery. The widened mediastinum, fluid collection, and stranding indicate inflammation and infection in the mediastinum. The correct management is to start intravenous antibiotics to treat the infection and surgically debride the wound to drain the infected fluid collection. Choices A, B, and C are incorrect surgical procedures not indicated in this case. Choice D of observation alone would be insufficient to treat the established infection.E: Intravenous antibiotics and debridement of surgical wound 