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Febrile neutropenia is an oncologic emergency requiring prompt empiric, broad-spectrum anti-pseudomonal coverage within one hour of presentation. Key steps include immediate blood cultures (both peripheral and from central line lumens if present) and initiation of an anti-pseudomonal β-lactam such as cefepime, piperacillin–tazobactam, or meropenem. The presence of a tender, erythematous port site raises concern for catheter-related bloodstream infection and potential MRSA involvement, warranting the addition of vancomycin at presentation. Waiting for culture results (Option C) delays time-to-antibiotic, which correlates with higher mortality. Oral therapy (Option A) is inappropriate in a hemodynamically tachycardic patient with a suspected line infection. Delaying therapy for imaging (Option D) also violates time-critical standards. Risk stratification (e.g., MASCC or CISNE) guides disposition, but initial parenteral therapy is standard for high-risk features such as profound neutropenia (ANC <500), suspected line infection, and recent induction chemotherapy. Ongoing management includes daily reassessment, source control if needed, and de-escalation based on cultures and clinical response.