Final answer:
For a 53-year-old female with unexplained chronic medical issues, a multidisciplinary approach including mental health assessment could be beneficial. In Marisa's case, additional infectious disease screenings are needed while David with Crohn's disease correctly received treatment for pneumonia, and the other David potentially needs rabies testing due to his symptoms after a dog bite.
Step-by-step explanation:
The most appropriate management of a 53-year-old female with several chronic medical problems that lack a medical explanation despite extensive evaluation would be to consider a potential psychosomatic or functional disorder. Due to the complexity and chronic nature of her symptoms, a multidisciplinary approach including a primary care physician, specialists as indicated by her symptoms, and possibly mental health professionals, might be warranted to address possible psychological factors contributing to her symptoms.
For the patient Marisa, who is suffering from severe abdominal pain, swollen lymph nodes, fatigue, and a fever after traveling, further tests to consider would include infectious disease screenings pertinent to the areas she visited, complete blood count, and possibly imaging studies to rule out infectious or inflammatory conditions.
For David with Crohn's disease presenting with fever, cough, and shortness of breath, the chest X-ray showing consolidation is indicative of pneumonia. The prescription of levofloxacin is an appropriate treatment, and follow-up is essential to assess the resolution of symptoms. In the case of David the journalist with symptoms after a dog bite, a culture and sensitivity test was conducted, and when that returned negative, further tests to consider could include rabies serology given the history of the bite and his travel history.