A 35 year Port Elizabeth resident presented with haematemesis 4 days after the onset of fever and myalgia. He gave a history of frequent travel to the major cities in the course of his work as a pilot. He also goes hunting most weekends in the Aberdeen area of the Eastern Cape.
A gastric bleed was suspected and he was referred to the surgical unit. Blood results taken pre- gastroscopy were:
A 19 year old university student traveled on a football tour to the Northern Cape for the past 7 days and returned last night. During the tour they stayed in hostels in various towns and also visited a farm for a farewell braai the night before the last match. On the day of his return he scored 4 goals in a match at the University.
At lunch time he complained of feeling unwell and feverish. By 16h00 he was vomiting, had a temp of 40C and seemed a b it sleepy. At 21h00 he was taken to hospital with bruising of the skin. By midnight he was hypotensive, semi-comatose and bleeding from puncture and intravenous catheter sites. At 01h00 hrs he had a cardio respiratory arrest requiring resuscitation.
Blood results on admission:
A 38 year old man from Johannesburg presented with a one week history of fever and nausea and abdominal pain for which he had taken symptomatic treatment. On day 7 of his illness he was confused with a temperature of 40C, and had no skin lesions / rashes. He was previously completely well, and had a history of travel 1 month ago to the Kruger Park. Over the next 24 hours he became hypotensive, developed ARDS, was bleeding everywhere with DIC, and went into renal failure Initial blood results:
Question 1: What are the important differential diagnoses?Continue to Answer 1