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.
McCullen, MD, Mary Kate
"Woman with relapsing fevers,"
The Medicine Forum:
Vol. 8, Article 10.
Available at: http://jdc.jefferson.edu/tmf/vol8/iss1/10