Recent travel with high fever, headache, N/V, myalgia followed by a rash.

Recent travel with high fever, headache, N/V, myalgia followed by a rash.

• A. Malaria
• B. Chikungunya
• C. Dengue Fever
• D. Yellow Fever

Answer: (C)

Dengue fever is most likely here because the pattern fits a classic travel-associated viral illness with a high fever, intense headache (often retro-orbital), nausea/vomiting, and prominent muscle pains, followed by a rash. It’s caused by a dengue virus transmitted by Aedes mosquitoes. The fever tends to be abrupt and can be very high, with severe body aches described as “breakbone fever.” A rash commonly appears as the fever begins to subside, and some patients develop low platelets, which can lead to easy bruising or mild bleeding in more severe cases. Malaria can present with fever and headache after travel, but the hallmark cycles of fever with chills and sweating, plus potential anemia and splenomegaly, are less described here, and a rash is not typical. Chikungunya also causes fever and severe joint pain, and a rash can occur, but the most distinctive feature is the debilitating arthralgia rather than the retro-orbital headache and the sequence of fever then rash. Yellow fever can present with fever and muscle pains and may include jaundice and bleeding, but the rash pattern and retro-orbital symptoms are less characteristic than dengue.

Dengue fever is most likely here because the pattern fits a classic travel-associated viral illness with a high fever, intense headache (often retro-orbital), nausea/vomiting, and prominent muscle pains, followed by a rash. It’s caused by a dengue virus transmitted by Aedes mosquitoes. The fever tends to be abrupt and can be very high, with severe body aches described as “breakbone fever.” A rash commonly appears as the fever begins to subside, and some patients develop low platelets, which can lead to easy bruising or mild bleeding in more severe cases.

Malaria can present with fever and headache after travel, but the hallmark cycles of fever with chills and sweating, plus potential anemia and splenomegaly, are less described here, and a rash is not typical. Chikungunya also causes fever and severe joint pain, and a rash can occur, but the most distinctive feature is the debilitating arthralgia rather than the retro-orbital headache and the sequence of fever then rash. Yellow fever can present with fever and muscle pains and may include jaundice and bleeding, but the rash pattern and retro-orbital symptoms are less characteristic than dengue.