Fresh water exposure, high fever, severe headache, myalgia, hepatitis, conjunctivitis without purulent discharge.

Fresh water exposure, high fever, severe headache, myalgia, hepatitis, conjunctivitis without purulent discharge.

• A. Dengue Fever
• B. Leptospirosis
• C. Malaria
• D. Typhoid Fever

Answer: (B)

Fresh-water exposure with abrupt high fever, severe headache, myalgias, hepatic involvement, and conjunctival injection without purulent discharge points to leptospirosis. The bacteria are transmitted through water contaminated with urine from infected animals; people often contract it after swimming, wading, or working in contaminated fresh water. A distinctive clue is conjunctival suffusion—red eyes without discharge—reflecting the systemic spread of the organism and its tendency to involve the liver, causing hepatitis-like signs. Dengue can cause fever, headache, and myalgias and may affect the liver, but transmission is via mosquitoes, not freshwater exposure, and conjunctival suffusion is not a typical feature. Malaria presents with fevers that cycle and often notable anemia, but conjunctival injection is uncommon. Typhoid fever has stepwise fever and prominent GI symptoms and does not usually involve the eyes in this conjunctival pattern or exposure to fresh water.

Fresh-water exposure with abrupt high fever, severe headache, myalgias, hepatic involvement, and conjunctival injection without purulent discharge points to leptospirosis. The bacteria are transmitted through water contaminated with urine from infected animals; people often contract it after swimming, wading, or working in contaminated fresh water. A distinctive clue is conjunctival suffusion—red eyes without discharge—reflecting the systemic spread of the organism and its tendency to involve the liver, causing hepatitis-like signs.

Dengue can cause fever, headache, and myalgias and may affect the liver, but transmission is via mosquitoes, not freshwater exposure, and conjunctival suffusion is not a typical feature. Malaria presents with fevers that cycle and often notable anemia, but conjunctival injection is uncommon. Typhoid fever has stepwise fever and prominent GI symptoms and does not usually involve the eyes in this conjunctival pattern or exposure to fresh water.