ABSTRACT
A 23-year-old medical student returned from his 8-week elective placement in India and attended hospital within hours of returning to the United Kingdom. He complained of a 2-day history of high fevers, nausea and headaches. He had vomited twice that day and also described a vivid maculopapular rash over his trunk, which had faded over the duration of his flight home. His friends who had accompanied him for his hospital placement had examined him prior to their flight home and had identified both neck stiffness and photophobia. The patient described widespread myalgia and arthralgia but denied joint swelling. He had no significant past medical history and took no regular medications. He admitted to occasional amphetamine use but had never injected drugs. He had unprotected sexual intercourse with a female partner several times during his recent trip to India. He had not travelled elsewhere during the preceding 12 months. He had not taken malaria prophylaxis or used insect repellent. His travelling companions were well.
