Travel Related Fever Due to an Emerging Infection

Laura Lee Newell Lab M-W 10:30 Microbiology Case Study #1

“Travel Related Fever Due to an Emerging Infection”

1.

What are this patient's most striking clinical and laboratory findings? Rapid heart rate, fever, migrating joint pain, especially in shoulder and bilateral thighs, normal white blood cell count with a minimal but noted low platelet count which affects blood clotting, slightly elevated liver function tests, and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevated level, which indicates increase level of inflammation.

2.

What should be considered when evaluating a patient with travel-related fever? Research diseases that is prominent in the area that he traveled in. When traveling to developed and underdeveloped nations, it helps to consider if the patient has received any prophylactic medication therapy or immunizations prior to traveling, whether they are just visiting family or traveling abroad on holiday.

3.

How do you explain this patient's most striking clinical and laboratory findings? Pt. is tachycardia and febrile indicating possible septic process. He has generalized body aches and joint aches, tender abdomen. Because his CK was within normal limits, Rhabodomyolisis is ruled out. His LFT’s, ESR & CRP are elevated indicating inflammatory and//or infectious process. Because the patient in this case visited Bangladesh, part of SouthCentral Asia, one should focus on travel-related diseases that are common in this region.

4.

What additional laboratory tests should be ordered and why? Blood cultures to find out what if any bacterium in the blood is causing these symptoms in order for the doctor to prescribe the right antibiotics. Blood cultures should be ordered to help rule out many of the international causes of travel-related fever It wouldn’t hurt to check for Malaria because he did not get pre-immunized for it. It would be worth checking the immunoglobins for Dengue as well as a Typhoid fever...