An Atypical Case of Gastroenteritis in a Traveler Returning from a Trip in Southeast Asia

Abstract

A healthy 34-years-old man came to the emergency department because he presented with fever and gastrointestinal symptoms (vomit and diarrhea) following a 3 weeks trip to Indonesia, Malaysia, and Singapore. Due to the lack of antimalarial prophylaxis and several insect bites, we tested the patient and malaria was definitively ruled out. The patient was in a discrete condition, so the initial hypothesis was febrile gastroenteritis. Only at the follow-up visit, due to the appearance of other symptoms (diffused exanthema), the diagnosis of dengue was taken into account and then confirmed by serological tests. The differential diagnosis of fever in the returning traveler is extensive and dengue must be taken into consideration even if with atypical presentation.