A 25-year-old man returns from a dengue-endemic area with 5 days of high fever, severe headache, retroorbital pain, and myalgia. His platelet count has dropped from 180,000 to 42,000/μL. He has no bleeding but shows a positive tourniquet test. What is the most appropriate management?
- A IV antibiotics for probable bacterial sepsis
- B Oral hydration, paracetamol, and close monitoring of CBC and hematocrit ✓
- C Immediate platelet transfusion
- D Oseltamivir antiviral therapy
Correct answer: B. Oral hydration, paracetamol, and close monitoring of CBC and hematocrit
Explanation
This is dengue fever (probable dengue with warning signs based on thrombocytopenia and positive tourniquet test). Dengue is a viral illness with no specific antiviral treatment. Management is supportive: oral rehydration, paracetamol for fever (aspirin and NSAIDs are contraindicated due to bleeding risk), and monitoring of CBC and hematocrit for dengue hemorrhagic fever/dengue shock syndrome. Prophylactic platelet transfusion is not recommended; it is reserved for significant bleeding or pre-procedure with platelets < 10,000/μL.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.