Health Dictionary

Patient Presentation

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.

Patient History

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.

Physical Exam

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.

Diagnostic Approach

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.

Management

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.

References

↑ Kahlon SS, Peters CJ, Leduc J, et al. Severe Rift Valley fever may present with a characteristic clinical syndrome. Am J Trop Med Hyg. 2010;82(3):371-375. doi:10.4269/ajtmh.2010.09-0669

Rift valley fever case study one