TY - CHAP M1 - Book, Section TI - Zika, Ebola, and Other Emerging Infections 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. PY - 2019 T2 - The Color Atlas and Synopsis of Family Medicine, 3e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/17 UR - dermatology.mhmedical.com/content.aspx?aid=1164343134 ER -