A 24-year-old man presents with fever for 3 days. Dengue NS1 antigen is positive. Platelet count is 1,55,000 per microlitre. He is haemodynamically stable, ambulatory, has no abdominal pain, no persistent vomiting, and no mucosal bleeding. What is the most appropriate management?

• A Admit and start prophylactic intravenous crystalloids
• B Start aspirin for fever and myalgia
• C Arrange prophylactic platelet transfusion
• D Manage as outpatient with paracetamol, oral hydration, and advice to return immediately if warning signs appear ✓

Explanation

This patient has dengue without warning signs and a normal platelet count, so home management with paracetamol, adequate oral fluids, and clear advice on warning signs is appropriate, with review during the critical phase around days 4 to 6. Platelet counts fall naturally and transfusion is reserved for spontaneous bleeding or counts below 10,000 without bleeding risk factors. NSAIDs such as aspirin are avoided because of antiplatelet effects. Prophylactic IV fluids are unnecessary in stable outpatients.

Reference: Clinical Guidance for Dengue, NVBDCP, 2015 ed.

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Written and medically reviewed by the StethoPrep medical team.