ABSTRACT
A 29-year-old man presented to the emergency department complaining of fever and headache. He had become unwell 48 hours earlier, with symptoms of nausea, vomiting and widespread myalgia. He had been in South Sudan for the past fortnight, returning to the United Kingdom earlier that day (he came from the airport directly to hospital). He had been staying on his uncle's cattle farm in South Sudan. He had not noted any insect bites and had taken anti-malarial prophylaxis throughout his holiday. His partner accompanied him to South Sudan and had been well throughout the trip. The patient was born in South Sudan and had lived there until he was 12 years of age, when he came to live in the United Kingdom. He had no significant past medical history and took no regular medications aside from the current course of anti-malarial drugs. He worked as a journalist.
