History A 46-year-old man has presented to the emergency department complaining of fever, vomiting and general malaise. He describes experiencing fever and rigor every 8–12 hours for the past three days. He feels weak and tired, and has vomited several times. He has recently returned from a holiday in Ghana where he took part in a camping trip. He was previously fit and well with no medical problems and no regular medications. Examination This man is febrile (39.7°C) and tachycardic (100 beats/min).
He looks pale and his mucous membranes are dry. His abdomen is soft but tender at the left upper quadrant, where splenomegaly of approximately 8 cm is palpable. He has multiple skin lesions around his ankles, which he attributes to mosquito bites. Considering the possible diagnosis, what investigations would you recommend? *This case is from Docplexus Editorial Team for educative purposes…
