Rift valley fever case study one

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aakash Hans, MD[2]

• A 50 year old male presented to the hospital after he was being treated for malaria from an outpatient clinic.^[1]
• Patient reported fever, weight loss, body aches, loss of appetite, headache and generalized weakness.
• He was prescribed anti-malarial treatment (artemether-lumefantrine) from the outpatient clinic.
• No complaints of bleeding from any orifice was reported by the patient at presentation.

• The patient was a goat herder by occupation and reported living in his house a week before he started experiencing symptoms.
• He denied any ill livestock(goats), but recalled several mosquito bites during that time period.
• There was no history of similar symptoms in any of his family members or acquaintances.

• Upon presentation to the hospital he had yellowish discoloration of his eyes along with pain in the right upper quadrant of his abdomen.
• On palpation he was found to have enlarged liver and enlarged spleen.
• There were no signs of joint tenderness or any swelling.
• He had low blood pressure without raised heart rate. Lowest blood pressure recorded was 65/40 mm of Hg which was confirmed by measuring the blood pressure in both arms.
• He also developed erythema in the sub-conjunctival region and began to feel disoriented.

• RT-PCR test was performed on Day-3 of his illness, which came out to be positive.
• Ig M antibody test was done on the same day and also tested positive.

• The patient was given supportive care in the form of intravenous fluids.
• Patient improved slowly over the course of five days and his blood pressure improved along with his disorientation.

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