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Abstract

A 50 year-old Nigerian woman with a past medical history significant for type II diabetes and hypertension presented to the ED with a chief complaint of recurrent fevers and chills. The patient was in her usual state of health until approximately 6 weeks prior to admission, while during a visit with family in Nigeria she noted the onset of high fevers and general malaise. Initially, her fevers occurred daily for a period of one week, and were associated with chills, fatigue, loss of appetite, and myalgias. During this time, she was not evaluated by a physician, nor did she take any medication. Her symptoms seemed to resolve however, and she felt reasonably well. She then returned home to the United States, approximately 4 weeks prior to admission. Upon return, she again experienced one week of recurring fevers/chills, as well as the above generalized symptoms. With no evaluation or intervention, her symptoms improved. Two weeks later, the same pattern of symptoms returned and the patient reported to the ED.

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