West Nile virus typically presents with fever and headache after a mosquito bite. Which is the recommended initial management?

West Nile virus typically presents with fever and headache after a mosquito bite. Which is the recommended initial management?

• A. Corticosteroids
• B. Ribavirin
• C. Supportive therapy
• D. Antiviral therapy

Answer: (C)

West Nile virus infections with fever and headache are typically self-limited, and there is no proven antiviral or vaccine for routine use. The best initial management is supportive care aimed at comfort and hydration. This includes ensuring adequate fluids, rest, and symptomatic relief with fever reducers such as acetaminophen (and NSAIDs as appropriate). Reserve escalation for signs of more serious disease: if there are symptoms suggesting neuroinvasive involvement (altered mental status, confusion, neck stiffness, focal neurologic deficits, severe headache, or vomiting) or dehydration that cannot be managed outpatient, patients should be admitted for IV fluids, careful monitoring, and further evaluation. In uncomplicated cases, corticosteroids, ribavirin, or other antiviral therapies do not have proven benefit and are not part of routine management.

West Nile virus infections with fever and headache are typically self-limited, and there is no proven antiviral or vaccine for routine use. The best initial management is supportive care aimed at comfort and hydration. This includes ensuring adequate fluids, rest, and symptomatic relief with fever reducers such as acetaminophen (and NSAIDs as appropriate).

Reserve escalation for signs of more serious disease: if there are symptoms suggesting neuroinvasive involvement (altered mental status, confusion, neck stiffness, focal neurologic deficits, severe headache, or vomiting) or dehydration that cannot be managed outpatient, patients should be admitted for IV fluids, careful monitoring, and further evaluation. In uncomplicated cases, corticosteroids, ribavirin, or other antiviral therapies do not have proven benefit and are not part of routine management.