A 7-year-old boy has 4 days of fever with NS1 antigen positive dengue. Platelet count is 55,000 per mm3. He has persistent vomiting, severe abdominal pain and lethargy. The correct next step is:
- A Admit immediately for management of dengue with warning signs ✓
- B Continue oral fluids at home and review after 48 hours
- C Start empiric antibiotics for presumed enteric fever co-infection
- D Arrange urgent platelet transfusion as outpatient
Correct answer: A. Admit immediately for management of dengue with warning signs
Explanation
Persistent vomiting, severe abdominal pain and lethargy are WHO/NVBDCP warning signs that mandate hospital admission for close monitoring of plasma leakage and shock, typically around defervescence. Thrombocytopenia alone does not require transfusion; platelet transfusion is reserved for active significant bleeding or count below 10,000 with high bleeding risk, which makes option D the classic trap.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.