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Fever and Headache after a Vacation in Thailand.

Abstract History 50 year-old man with fever and headache starting one week after returning from his vacation in Thailand. His general practitioner prescribed amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. Examinations The examination of cerebro-spinal fluid was crucial for the final diagnosis. Lumbar puncture demonstrated a predominantly mononuclear pleocytosis of 80 cells/µl (< 5) with an elevated protein of 782 mg/l (< 450); glucose and lactate were within normal limits. Treatment and course Initially we tried to treat a broad range of organisms potentially causing meningitis or encephalitis. Typical bacteria and viruses endemic to Switzerland were not found, thus anti-infective treatment was stopped. Also the search for malaria, HIV, Chikungunya and Dengue infections yielded negative results. After 10 days we received a positive serologic test for Japanese encephalitis virus (JEV). Conclusions The Japanese encephalitis virus is transmitted by mosquitoes and is epidemiologically one of the most important transmissible neurologic diseases in Asia. Although only a minority of infected patients are gravely ill, their sequelae and death toll are considerable. Since 2009 a well-tolerated vaccine is available.
PMID
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Authors

Mayor MeshTerms

Travel

Keywords
Journal Title deutsche medizinische wochenschrift (1946)
Publication Year Start


 


PMID- 28728201
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170818
LR  - 20170818
IS  - 1439-4413 (Electronic)
IS  - 0012-0472 (Linking)
VI  - 142
IP  - 14
DP  - 2017 Jul
TI  - [Fever and Headache after a Vacation in Thailand].
PG  - 1063-1066
LID - 10.1055/s-0043-106282 [doi]
AB  - History 50 year-old man with fever and headache starting one week after returning
      from his vacation in Thailand. His general practitioner prescribed
      amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. 
      Examinations The examination of cerebro-spinal fluid was crucial for the final
      diagnosis. Lumbar puncture demonstrated a predominantly mononuclear pleocytosis
      of 80 cells/microl (&lt; 5) with an elevated protein of 782 mg/l (&lt; 450); glucose
      and lactate were within normal limits. Treatment and course Initially we tried to
      treat a broad range of organisms potentially causing meningitis or encephalitis. 
      Typical bacteria and viruses endemic to Switzerland were not found, thus
      anti-infective treatment was stopped. Also the search for malaria, HIV,
      Chikungunya and Dengue infections yielded negative results. After 10 days we
      received a positive serologic test for Japanese encephalitis virus (JEV).
      Conclusions The Japanese encephalitis virus is transmitted by mosquitoes and is
      epidemiologically one of the most important transmissible neurologic diseases in 
      Asia. Although only a minority of infected patients are gravely ill, their
      sequelae and death toll are considerable. Since 2009 a well-tolerated vaccine is 
      available.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Schwermer, Benedikt
AU  - Schwermer B
FAU - Eschle, Daniel
AU  - Eschle D
FAU - Bloch-Infanger, Constantine
AU  - Bloch-Infanger C
LA  - ger
PT  - Case Reports
PT  - Journal Article
TT  - Fieber und Kopfschmerzen nach Thailandurlaub.
DEP - 20170720
PL  - Germany
TA  - Dtsch Med Wochenschr
JT  - Deutsche medizinische Wochenschrift (1946)
JID - 0006723
RN  - 0 (Japanese Encephalitis Vaccines)
SB  - IM
MH  - Diagnosis, Differential
MH  - Encephalitis, Japanese/*diagnosis/therapy/*virology
MH  - Fever of Unknown Origin/*diagnostic imaging/prevention &amp; control/*virology
MH  - Headache/*diagnostic imaging/prevention &amp; control/virology
MH  - Humans
MH  - Japanese Encephalitis Vaccines/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Switzerland
MH  - Thailand
MH  - *Travel
MH  - Treatment Outcome
COI - Disclosure The authors report no conflicts of interest in this work.
EDAT- 2017/07/21 06:00
MHDA- 2017/08/19 06:00
CRDT- 2017/07/21 06:00
AID - 10.1055/s-0043-106282 [doi]
PST - ppublish
SO  - Dtsch Med Wochenschr. 2017 Jul;142(14):1063-1066. doi: 10.1055/s-0043-106282.
      Epub 2017 Jul 20.