An 85-year-old female with chronic obstructive pulmonary disease presents to the emergency department during flu season. She reports a two-day history of myalgia, fever, and worsening cough. She lives alone and hasn’t received her annual flu vaccine. Considering the patient's age and history, what is the most effective intervention to administer at this point?
Initiate antiviral therapy within the first 48 hours
Obtain a high-resolution CT scan to evaluate for possible pneumonia
Prescribe antibiotics to prevent secondary bacterial infection
Provide supportive care only, such as hydration and antipyretics
For patients presenting with symptoms consistent with influenza, especially those in high-risk categories such as the elderly or those with pre-existing conditions like COPD, initiating antiviral therapy as soon as possible, but particularly within the first 48 hours of symptom onset, is crucial. This approach helps reduce the severity and duration of symptoms, and is critical in preventing further complications. In contrast, delaying specific antiviral treatment in hopes of observing effects of supportive care can lead to worse outcomes, and high-resolution CT is usually reserved for diagnostic clarity when additional complications are suspected, not routinely used for uncomplicated flu.
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