MRCP2-2599

A 25-year-old Caucasian woman returned from a two week hiking trip in Peru four days ago. She had not taken malaria prophylaxis. She had been drinking alcohol moderately during her trip. She had unprotected sex during her holiday with a local man.

Yesterday she had felt hot and cold with pain all over her body and a headache. Today the pain is worst behind her eyes. It is a constant pain and there is no photophobia or neck stiffness. She has an erythematous rash over her trunk and back with patches of white skin surrounded by erythema. There is no lymphadenopathy.

She is observed in hospital for 48 hours and tests for HIV (including PCR and antibody), malaria and blood cultures were negative. Further tests remain unreported.

She recovers and is feeling much better. Prior to discharge, she asks if she is safe to go back to Peru next year.

What advice would you give her?