33-Year-old liver transplant recipient returns from hunting trip in sudan with intermittent fevers and gross hematuria

Abstract

Patient: 33-year-old male. Chief Complaint: Intermittent fevers, joint pain, gross hematuria Past Medical History: Eight years status post orthotopic liver transplant for hepatitis B virus and hepatocellular carcinoma. Allograft is stable with no evidence of rejection. Medications: Prograf and tenofovir Physical Exam Findings: Alert, oriented, thin gentleman, no thrush. Family History: Adopted, unknown Social History: Recent travel to Sudan and Kenya for 3 weeks on a hunting trip; returned 3 weeks prior to admission. The patient reports several mosquito exposures and ate buffalo, which he skinned and cooked on the riverbank. He walked through flood waters from the Nile River but did not swim in any lakes or rivers.