Dr Albie de Frey and Mrs Lee Baker
A 30-yr old male returned from a 14-day holiday in Italy having spent 4 days in Rome and 10 days on the Amalfi beach. He stayed in a privately rented apartment with a balcony where he often sat in the late afternoon/early evening.
On the last two days of the holiday he noted the skin lesions (see photo) on his feet and lower legs.
Four days back in Johannesburg he developed a febrile illness with night sweats and chills, headache, muscle and joint pain and malaise. His transaminases were mildly raised but FBC was normal.
He had all his childhood vaccines but an unremarkable past medical history since. He did not seek pre-travel advice prior to departing for Italy as he deemed it unnecessary.
Question 1: Discuss the differential diagnosis in this patient with particular reference to the geographic area from which the patient returned?Continue to Answer 1