At noon report we discussed how the constellation of recent travel to the Caribbean, mosquito bites, fever, intractable headache, hematuria, and pulmonary infiltrates may have been a case of Dengue Fever.

Here are some learning points:

Illness Script for Dengue Fever:  Caused by a virus with a mosquito vector epidemic to the Carribean, South and Central America, and Asia.  It causes a wide range of symptoms including fever, headache, retro-orbital pain, muscle and joint pain, rash, and fatigue, with or without minor spontaneous bleeding manifestations

Diagnosing Dengue Fever: Serologic testing results will depend on the day of the illness:

And finally, the article that walks through a seemingly complicated though very helpful chart of the Approach to Fever in the Returning Traveler, NEJM 2017