A 27-year-old African woman with acute febrile illness

Vitorino Modesto Santos, Victor Manabu Yano, Heloisa Costa Ravagnani, Susana Moratelli Pinho


We report the case of a 27-year-old African woman who searched for medical attention because of high fever, headache, dizziness, arthralgia, nausea, abdominal pain and vomiting, followed by severe pulmonary disorder and arterial hypotension responsive to volume expansion. Initial laboratory determinations revealed leukopenia, high rate of band neutrophils, low platelets, anemia, high erythrocyte sedimentation rate and C-reactive protein, and elevated liver enzymes. Radiographic and tomographic studies showed bilateral pulmonary infiltrates and pleural effusion. The patient reported antecedent of travels to Africa as well as to Brazilian Amazon region, and the clinical manifestations began one week after she underwent an elective gynecologic surgery. Diverse schedules of antimicrobials had to be employed, and the infection was finally controlled. Our aim is to comment differential diagnosis of tropical zoonosis and postoperative infection.

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