Vexing vectors

Abstract

A 50-year-old woman presented to the Urgent Care Clinic with myalgias, lymphadenopathy, and rash 3 days after returning from a trip to the KwaZulu-Natal province of South Africa. There she had worked as a volunteer healthcare provider, participating in home visits to patients with human immunodeficiency virus infection and tuberculosis. One month prior to departure, she visited a travel clinic and received hepatitis A, hepatitis B, and typhoid fever vaccines. She received a prescription for atovaquone/proguanil (Malarone) for malaria prophylaxis and was counseled on insect precautions.