Cold shivers after a hot trip

General Data

• 33 y/o• News correspondent

History of Present Illness

• He had a 3 month assignment in Palawan• Took chloroquine weekly for malaria prophylaxis

• Fever, chills, and headache 2 weeks

• Treated with sulfadoxine-pyrimethamine (Fansidar)• 2 other companions also experienced similar symptoms

Physical Examination• Ill-looking but well-nourished male• Temperature – 40˚C• PR 110 bpm• RR 22 breaths per minute• BP 120/60• Pale palpebral conjunctiva• Icteric sclera• Pupils equally reactive to light• JVP is normal• (-) thyromegaly• Heart and Lungs are normal• Traube’s space is obliterated• No skin lesions nor pedal edema

Objective Findings

Positive• High Fever • Tachycardia• Tachypnea• Icteric Sclera• Splenomegaly

Negative• Absence of skin

lesions