MRCP2-2686

MRCP2-2686

As the doctor on call you are called to review a 29-year-old male on the haematology ward. He recently underwent an allogenic stem cell transplant, which so far had been reasonably uncomplicated. Earlier in the week the patient had complained of coryzal symptoms and a dry cough. A nasopharyngeal aspirate (NPA) had been sent along with other routine tests 24 hours ago.

When you arrive to review the patient on the ward you note that he appears extremely sweaty. You take his temperature using a tympanic thermometer which reads 39.5ºC. His heart rate is 95 beats per minute and his respiratory rate is 16 breaths per minute. Blood pressure is 122/76 mmHg. Physical examination is unremarkable and chest X-ray reveals clear lung fields.

You review the patient’s most recent results:

Hb 95 g/l Na+ 134 mmol/l
Platelets 50 * 109/l K+ 3.6 mmol/l
WBC 0.1 * 109/l Urea 3.0 mmol/l
Neuts 0.1 * 109/l Creatinine 65 µmol/l
Lymphs 0.0 * 109/l CRP 12 mg/l
Eosin 0.0 * 109/l
NPA Influenza A

What is the most appropriate treatment to commence?