RT Book, Section
A1 Hall, Jeffrey W. W.
A1 Haldeman, Matthew S.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164343134
T1 Zika, Ebola, and Other Emerging Infections
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK dermatology.mhmedical.com/content.aspx?aid=1164343134
RD 2024/04/19
AB A  35-year-old  graduate  student  at  the  local  university  returned  from  visiting  his  family  in  Liberia  over  the  summer.  He  has  been  back  in  the  United  States  for  a  week,  and  three  days  ago  he  began  having  fevers  up  to  40°C  (104°F).  He  has  had  shaking  chills,  significant  body  aches,  and  a  faint  papular  rash  noted  on  his  torso.  Initial  laboratory  studies  include  a  single  negative  malaria  smear  and  a  negative  malaria  rapid  diagnostic  test.  A  CBC  reveals  WBC  count  of  5000  with  a  left  shift  noted,  and  his  platelet  count  is  low  at  120,000.  Upon  further  history,  the  student  reported  a  tick  bite  while  visiting  his  family  in  the  rural  parts  of  the  country.  He  reports  no  known  contact  with  ill  people  or  participation  in  any  funerals  or  burial  rituals  in  the  country.  He  is  admitted  to  the  hospital  for  supportive  management.  Because  of  his  history  of  recent  travel  to  western  Africa,  the  Centers  for  Disease  Control  and  Prevention  (CDC)  is  notified,  and  serologies  for  Ebola,  dengue,  chikungunya,  and  African  tick-bite  fever  are  sent.  In  addition  to  careful  fluid  and  electrolyte  management,  he  is  empirically  started  on  doxycycline  for  the  possibility  of  rickettsial  diseases  while  awaiting  the  results  of  the  serologic  tests.  After  24  hours,  his  fever  improves,  and  he  is  monitored  for  vascular  leakage  and  hypotension,  but  recovers  well.  IgM  for  dengue  ultimately  returns  positive.