Special Operations Forces Medical Handbook

3-33

Acutely Ill Patient

Temp > 101°F

Petechiae, Purpura, Ecchymoses

and/or Jaundice present

NO YES

• Possible Hemorrhagic Fever


• Consider Meningococcal Infection


• Strict isolation until diagnosis clear


• Consider Prophylaxis (Cipro) for exposed persons

Systolic BP < 80 mm

NO YES

• 2 large bore IV lines (16 G)
  
  
  • 1-2 L NS or Ringers ASAP
    -Obtain lab specimen
  
  
  
  


• Initiate IV Antibiotics


• Chloramphenicol if available
  or Ceftriaxone 2 GM


• Evacuate

YES

• Malaria smears, White Blood Cell count,
  Chem strip, Urinalysis

Yes Exam shows Focal Neuro Signs or Papilledema No

• Refer for CT
  Head ASAP
  
  
  • Ceftriaxone 2GM IV if not Penicillin Allergic
    
    
    • Chloramphenicol is alternate
    
    
    
    
  
  
  
  

+ Start

Refer for Lumbar Puncture

NO CSF results show Meningitis YES

Continue Antibiotics

Repeat

Malaria Smears

NEGATIVE POSITIVE

• Initiate Typhus RX


• If Hypotension give
  Ceftriaxone +
  Ciprofloxacin as well


• Treat for Malaria
  (Falciparum)

RASH

NO

NO YES

Headache or

Altered Mental Status