# Rash and Fever in a Returned Traveler

## TL;DR

A young woman who traveled to Ghana developed fever and rash, leading to a dengue diagnosis, highlighting the importance of considering tropical diseases in returning travelers.

## Contribution

This case emphasizes the need for emergency physicians to consider dengue and other tropical illnesses in febrile returning travelers.

## Key findings

- A 21-year-old female with fever and rash was diagnosed with dengue after returning from Ghana.
- Physical exam findings like petechiae and rash can guide the diagnosis of dengue in travelers.
- Emergency physicians should maintain a broad differential for febrile illnesses in returned travelers.

## Abstract

A 21-year-old, otherwise healthy female presented to the emergency department with fever among other nonspecific symptoms after recently returning from Ghana. On physical exam, she had a characteristic upper extremity rash, and a tourniquet test revealed numerous petechiae. The diagnosis of dengue was suspected and subsequently confirmed.

Dengue is one of many viral illnesses that should be considered in returning travelers presenting with fever and other nonspecific symptoms. Emergency physicians must keep a broad differential when evaluating fever in returned travelers and prioritize history and physical exam findings to help narrow the diagnosis and provide appropriate management and supportive care while awaiting further confirmatory testing.