It has been 2 weeks since a tropical caver researcher returned from Uganda, she is experiencing flu-like symptoms such as fever, sore throat and muscle aches, after 6 days condition deteriorates with the onset of diarrhoea, vomiting and stomach ache. The doctor's examination revealed rashes and leakage of the blood vessels in her eyes. Further hospital tests revealed internal bleeding. Case history showed she had been collecting samples from caves close to the border with the Democratic Republic of the Congo which had significant bat activity. According to laboratory results, the patient has proteinuria, increased serum transaminases, leukopenia (1x109 /L), and thrombocytopenia (10x109 /L). She has normal lung function but an enlarged liver and spleen.  Blood film screening for malaria was negative as well as diagnostic tests for the following haemorrhagic viruses: Dengue fever virus, Crimean-Congo haemorrhagic fever virus, Marburg virus, Rift Valley fever virus, Lassa fever virus and Hantavirus. Provide a differential and presumptive diagnosis.

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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It has been 2 weeks since a tropical caver researcher returned from Uganda, she is experiencing flu-like symptoms such as fever, sore throat and muscle aches, after 6 days condition deteriorates with the onset of diarrhoea, vomiting and stomach ache. The doctor's examination revealed rashes and leakage of the blood vessels in her eyes. Further hospital tests revealed internal bleeding. Case history showed she had been collecting samples from caves close to the border with the Democratic Republic of the Congo which had significant bat activity.

According to laboratory results, the patient has proteinuria, increased serum transaminases, leukopenia (1x109 /L), and thrombocytopenia (10x109 /L). She has normal lung function but an enlarged liver and spleen.  Blood film screening for malaria was negative as well as diagnostic tests for the following haemorrhagic viruses: Dengue fever virus, Crimean-Congo haemorrhagic fever virus, Marburg virus, Rift Valley fever virus, Lassa fever virus and Hantavirus.

Provide a differential and presumptive diagnosis. 

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