Published 19 August 2009, doi:10.1136/bmj.b2985
Cite this as: BMJ 2009;339:b2985

Endgames

Case report

Fever in the vaccinated returning traveller

James Powell, ST1 core medical trainee in infectious diseases

1 Flat 6, 233 Acton Lane, Chiswick, London W4 5DD

jbpowell@doctors.org.uk

The first 150 words of the full text of this article appear below.

A 64 year old woman presented to hospital with fevers, chills, lethargy, and poor appetite. The symptoms had begun six days previously, when returning to the United Kingdom after a three week holiday visiting friends and family in Gujarat, India. She also felt nauseous, had a moderately severe bilateral frontal headache, and was constipated. Her only medical history was a thyroidectomy in 1982. Before travelling she received all relevant vaccinations, including hepatitis A and B and typhoid fever. She had not taken malarial prophylaxis. Her only regular medication was thyroxine 150 µg once a day.

On examination the patient seemed well. Her temperature was 37.3°C, pulse 80 beats/min regular, blood pressure 101/67 mm Hg, and respiratory rate 15 breaths/min. Her abdomen was soft but tender in the right upper quadrant, with no demonstrable organomegally; bowel sounds were normal.

Routine investigations showed a haemoglobin of 113 g/l, mean corpuscular volume 85 . . . [Full text of this article]


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