PLAB01-150

Alicia is a 24 year old student who has recently returned from travelling across East Africa volunteering in rural villages. Since returning to the UK five days ago, she has developed worsening diarrhoea, crampy abdominal pain and fevers. She has noticed some blood in her stool so attends the GP surgery. She is usually fit and well and has taken appropriate malaria chemoprophylaxis.

Observations:

Temperature: 37.5 °C
Pulse: 60 beats/minute
Blood pressure: 133/67
Respiratory rate: 16
Oxygen saturations: 99% on air

Examination:

No abdominal distension, mild tenderness to deep palpation, no masses, bowel sounds normal.
Cardiovascular, respiratory and neurological examinations are unremarkable.

What is the next best course of action?

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