Clinical Snapshot
Fever, Rash and Headache After Traveling to Thailand
; ;
A young adult presented to our clinic with headache, muscle and joint aches, diarrhea, fever (39.8° C), and a maculopapular rash all over his body. These symptoms appeared suddenly on the 10th day during a trip to Thailand. Since the clinical manifestations were suggestive of dengue fever, a dengue NS1 antigen rapid test was performed locally which was negative. On presentation at day 5 of illness, we found specific IgM and IgG antibodies to Zika virus, while serological testing for dengue and chikungunya was negative. The diagnosis of Zika virus infection was confirmed by a positive quantitative real-time reverse-transcription polymerase chain reaction (qRT-PCR) from a spot urine sample. The complaints subsided with symptomatic paracetamol treatment. An increase in Zika virus infections among travelers to Thailand has been observed since autumn 2023. Thus, in addition to dengue, Zika fever should be considered in the differential diagnosis of patients presenting with acute fever of unclear etiology and rash or conjunctivitis. Currently, no specific treatment is available; the clinical course is usually benign. Sexual transmission can occur during a period of several months; in pregnant women, severe congenital Zika syndrome with microcephaly and other malformations may occur as the result of a Zika virus infection. Thus, it is important to prevent sexual transmission during pregnancy (e.g. by using condoms).
Prof. Dr. med. Dr. phil. Sören L. Becker, Dr. med. Sophie Schneitler,
Ambulanz für Reise- und Tropenmedizin, Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum des Saarlandes, Homburg/Saar, soeren.becker@uks.eu
Dr. med. Martin Gabriel, Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
Conflict of interest: The authors declare no conflict of interest.
Translated from the original German by Ralf Thoene, MD.
Cite this as: Becker SL, Gabriel M, Schneitler S: Fever, rash and headache after traveling to Thailand. Dtsch Arztebl Int 2024; 121: 688a.
DOI: 10.3238/arztebl.m2024.0090
