<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A previously healthy 1-year-old boy is brought to the emergency department because of irritability and fever for 2 days. His symptoms began shortly after returning from a family trip to Canada. He was born at term. His immunizations are up-to-date. His 6-year-old brother is healthy and there is no family history of serious illness. The boy appears weak and lethargic. He is at the 50th percentile for height and 75th percentile for weight. His temperature is 39.2C 102.5F, pulse is 110min, respirations are 28min, and blood pressure is 9255 mm Hg. Physical examination shows several purple spots over the trunk and extremities that are 1 mm in diameter. Capillary refill time is 4 seconds. The remainder of the examination shows no abnormalities. His hemoglobin concentration is 12 gdL, leukocyte count is 19,000mm3, and platelet count is 225,000mm3. A lumbar puncture is done; cerebrospinal fluid CSF analysis shows abundant segmented neutrophils, decreased glucose concentration, and an increased protein concentration. Which of the following is the most appropriate next step in management?? A: Ampicillin therapy for the patient and ciprofloxacin prophylaxis for close contacts, B: Cefotaxime and vancomycin therapy for the patient and doxycycline prophylaxis for close contacts, C: Vancomycin therapy for the patient and rifampin prophylaxis for close contacts, D: Ceftriaxone and vancomycin therapy for the patient and rifampin prophylaxis for close contacts, E: Cefotaxime and vancomycin therapy for the patient and no prophylaxis for close contactsn,  <response>: Based on the clinical presentation of fever, irritability, purple spots on the skin, and CSF analysis showing increased neutrophils, decreased glucose, and increased protein, this patient likely has meningococcal meningitis. The choices provide different antibiotic options for treating the patient and giving prophylaxis to close contacts to prevent spread of the infection. The antibiotics need to cover Neisseria meningitidis. Choice A with ampicillin would not provide adequate coverage. Choices B, C, and E do not include rifampin, which is the preferred agent for chemoprophylaxis to eradicate nasopharyngeal carriage of N. meningitidis. D: Ceftriaxone and vancomycin therapy for the patient and rifampin prophylaxis for close contacts 