A 28-year-old man returns from Southeast Asia 3 weeks ago with severe cramping abdominal pain, profuse watery diarrhea, and diffuse myalgia. Vital signs show temperature 38.9°C, heart rate 104/min, blood pressure 108/72 mmHg, respirations 18/min, and SpO2 98% on room air. Stool culture is negative. Serum IgM antibodies to dengue virus non-structural protein-1 (NS1) are elevated. No hepatomegaly or petechiae are noted. Which of the following is the most appropriate next step in management?
- A)Vaccination with dengue tetravalent vaccine
- B)Colonoscopy to evaluate for inflammatory bowel disease
- C)Supportive care with careful fluid management and platelet monitoringGABARITO
- D)Immediate initiation of intravenous ribavirin
- E)Empiric broad-spectrum antibiotic therapy
Explicação
Dengue is a self-limited flavivirus infection. Management is supportive with careful fluid replacement and monitoring for dengue hemorrhagic fever/shock syndrome (watch for platelet drop, hemoconcentration). NS1 seropositivity in acute phase confirms dengue. N... Ver explicação completa e trilha adaptativa →