**Core Concept**
Neutropenia in a child can be a transient condition, and a watchful waiting approach is often the initial management strategy, especially when other parameters of the blood count are normal.
**Why the Correct Answer is Right**
In this scenario, the child is otherwise healthy, and all other parameters of the blood count are within normal limits. The bone marrow examination is also normal, which suggests that there is no underlying bone marrow failure or other serious condition causing the neutropenia. Therefore, a watchful waiting approach with regular follow-up CBCs is the most appropriate next step. This strategy allows for the identification of any changes in the neutrophil count or other parameters that may indicate the need for further investigation or treatment.
**Why Each Wrong Option is Incorrect**
**Option A:** Corticosteroid administration may be considered in cases of severe neutropenia or when there is a clear indication of an underlying cause, such as autoimmune neutropenia. However, in this scenario, the child's neutrophil count is only moderately decreased, and there is no indication of an underlying cause that would warrant corticosteroid therapy.
**Option B:** Multivitamin administration is not indicated in this scenario, as the child's nutritional status is not compromised, and there is no evidence of a vitamin deficiency causing the neutropenia.
**Option D:** Antibiotics to prevent infection are not necessary, as the child is otherwise healthy, and there is no indication of an increased risk of infection. Antibiotics would be considered if the child were to develop an infection or if there were other risk factors for infection.
**Clinical Pearl / High-Yield Fact**
In pediatric patients with isolated neutropenia, a watchful waiting approach is often the most appropriate initial management strategy, as many cases are transient and resolve spontaneously.
**β Correct Answer: C. Watch and wait strategy**
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