Infectious disease · case mode

Day 4 fever that just broke

A 24-year-old woman living in an endemic city has had 4 days of high fever, severe myalgia and retro-orbital pain. Today she is afebrile but has severe abdominal pain and repeated vomiting. Blood pressure 110/95 mmHg, pulse 108/min, platelets 55 × 10⁹/L, haematocrit risen from 38% to 47%.

moderate5 decisionsdengue

1
How do you interpret today's change?
2
Blood pressure is 110/95 mmHg with a pulse of 108. What does the pulse pressure tell you?
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3
Which fluid strategy is correct?
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4
Her platelets fall to 22 × 10⁹/L with no bleeding. What do you do?
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5
Forty-eight hours later she is stable with improving appetite, but now has bibasal crackles and mild breathlessness on the current fluid rate. What is happening?
Answer the previous step to continue.

Demo content. Educational decision support only. Verify every dose, citation and recommendation against your national formulary and the primary source before clinical use.

How do you interpret today's change?

Blood pressure is 110/95 mmHg with a pulse of 108. What does the pulse pressure tell you?

Which fluid strategy is correct?

Her platelets fall to 22 × 10⁹/L with no bleeding. What do you do?

Forty-eight hours later she is stable with improving appetite, but now has bibasal crackles and mild breathlessness on the current fluid rate. What is happening?