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Case of the Month - February 2017

A 68-year-old man presented with a 2-day history of fever, chills, myalgia and diarrhoea. He had recently returned from the Hluhluwe Game Park five days previously. He had not taken malaria prophylaxis, and there was no history of significant alcohol or recreational drug use, insect bites or contact with animals or animal products. Accommodation was at the luxury lodge in the game park.

A temperature of 39.2oC was the only clinical finding. His white cell count was 3 x 109/L, platelets 101 x 109/L, INR of 4.8, and elevated AST 570 IU/L and ALT 512 IU/L. A clinical diagnosis of acute hepatitis was made.

Question 1. What is your aetiological differential diagnosis?

Continue to Answer 1