SHM Converge Scientific Abstract ePoster Gallery-Fever in the Returning Traveler: Dengue in Wisconsin and the Indispensability of a Sage H&p

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This case describes a 58-year-old man who returned from a 14-day trip to the Philippines and developed fever, nausea, diarrhea, retro-orbital pain, and a diffuse erythematous rash within 48 hours. He had eaten at street markets, stayed in a beachside village north of Manila, and did not use mosquito precautions. On exam, he had orbital pain with extraocular movements and a blanchable rash with areas of pallor on the chest and upper extremities.<br /><br />Initial labs showed neutropenia and thrombocytopenia, raising concern for tick-borne illness or viral hemorrhagic fever. An extensive infectious workup was negative, including testing for anaplasmosis, ehrlichiosis, babesiosis, Lyme disease, chikungunya, malaria, leptospirosis, EBV, HIV, hepatitis A/B, CMV, and GI/respiratory panels. Dengue fever was confirmed by a positive serum IgM antibody.<br /><br />The patient was treated supportively with IV fluids and acetaminophen, improved without complications, and was discharged after receiving empiric doxycycline. The presentation highlights the importance of considering dengue in febrile returning travelers, especially after travel to endemic regions in Southeast Asia.<br /><br />The accompanying discussion emphasizes WHO dengue classification and clinical recognition. Dengue is transmitted by Aedes mosquitoes and typically has a 3–14 day incubation period. Common features include fever, retro-orbital pain, vomiting, myalgia, rash, thrombocytopenia, and sometimes hemorrhagic signs or plasma leakage in the critical phase. The article stresses the need for careful history-taking, risk stratification, and timely diagnosis to distinguish dengue from other causes of fever in travelers.

Asset Subtitle

Alexander W. Nelson

Meta Tag

Author List Alexander W. Nelson

Category Clinical Vignettes

Concept Dengue Fever

Concept Fever

Concept WHO Dengue Classification

Concept Supportive Care

Concept Severe Dengue

Distinguished Non-Finalist

Presenter Organization University of Wisconsin School of Medicine and Public Health

Presenting Author Alexander W. Nelson

Track Adult

Keywords

dengue fever

returning traveler

Philippines travel

retro-orbital pain

thrombocytopenia

neutropenia

Aedes mosquito

febrile rash

Southeast Asia

dengue IgM

Dengue Fever

Fever

WHO Dengue Classification

Supportive Care

Severe Dengue