A traveler returning from Africa presents with fever and a hemorrhagic rash. Which diagnosis is most consistent?

A traveler returning from Africa presents with fever and a hemorrhagic rash. Which diagnosis is most consistent?

• A. Typhoid
• B. Malaria
• C. Leptospirosis
• D. Viral Hemorrhagic Fever

Answer: (D)

Fever with a hemorrhagic rash after returning from Africa points to a viral hemorrhagic fever, because these infections characteristically cause abrupt febrile illness with bleeding due to widespread vascular injury and coagulopathy, and Africa is a region where VHFs such as Ebola/Marburg are encountered. While typhoid can present with fever and a faint trunk rash (rose spots) and malaria with fever and systemic illness, neither typically features a prominent hemorrhagic rash in this epidemiologic context. Leptospirosis can involve bleeding, but a distinct hemorrhagic rash is more characteristic of VHFs, and the travel-associated exposure makes the viral hemorrhagic fever diagnosis the best fit.

Fever with a hemorrhagic rash after returning from Africa points to a viral hemorrhagic fever, because these infections characteristically cause abrupt febrile illness with bleeding due to widespread vascular injury and coagulopathy, and Africa is a region where VHFs such as Ebola/Marburg are encountered. While typhoid can present with fever and a faint trunk rash (rose spots) and malaria with fever and systemic illness, neither typically features a prominent hemorrhagic rash in this epidemiologic context. Leptospirosis can involve bleeding, but a distinct hemorrhagic rash is more characteristic of VHFs, and the travel-associated exposure makes the viral hemorrhagic fever diagnosis the best fit.