A 30 year old camper is on a multi-day trek in the woods. After coming out, he goes to the emergency department complaining of headache, malaise, nausea, and dizziness. He is a little bit confused. His lips and skin are a bit flushed. Even after he recovers, he has variable degrees of cognitive deficits, personality changes, and movement disorders. His basic vital signs are normal, but you make the diagnosis based on a blood test.
Challenge: What's the diagnosis?
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Hello, my guess would be a tick-borne-encephalitis, or even Lyme's disease, even though the presentation would be atypical for the latter.
Lyme's disease would not be conclusive in a blood test, as many people undergo infection without any clinical presentation and so have specific Anti-bodies.
Another possibility is Rickettsia, as the tick-born encephalitis hasnt yet spread to more parts than Eurasia. (and is usually transmitted by Borrelia Burgdorferi, named after the place it was discovered in Switzerland.)
As rickettsia is present in NZ and Haemaphysalis longicornis, the tick , in NZ is found to be a vector of this disease to humans, the likelyhood is high.
good ideas - its not infectious!
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Camping
This is carbon monoxide poisoning, which can occur with smoke inhalation.
Source: UpToDate.
you see signs about carbon monoxide poisoning in NZ?
yep - on a bunch of treks in the south island
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