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A 16-year-old boy is brought to the emergency department because of a 2-day history of fever, nausea, vomiting,
headache, chills, and fatigue. He has not had any sick contacts. He underwent splenectomy for traumatic injury at
the age of 13 years. He has no other history of serious illness and takes no medications. He appears ill. His
temperature is 39.2°C (102.5°F), pulse is 130/min, respirations are 14/min, and blood pressure is 110/60 mm Hg. On
pulmonary examination, scattered crackles are heard bilaterally. Abdominal examination shows a well-healed
midline scar and mild, diffuse tenderness to palpation. Which of the following is the most appropriate next step in
management?
(A) Antibiotic therapy
(B) Antiemetic therapy
(C) CT scan of the chest
(D) X-ray of the abdomen
(E) Reassurance
can anyone explain what is the issue here
answer is A but what does the kid have ;pneumo or meningiococcal, why there is diffuse abdomen tenderness |
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