In this case the epidemiological background, clinical symptoms, leucopenia and thrombocytopenia suggests a possible Arbovirus infection called Chikungunya, Hemorrhagic Fever Viral infections, Leptospirosis, Rickettsiosis, Yellow fever, or possibly Malaria.

The patient was initially managed with IV crystalloid administration, and having only a modest improvement in blood pressured was transferred to an isolation area in the intensive care unit. Cultures and serological test were drawn. ELISA IgM test for Chikungunya infection was reported as negative, ELISA test for Yellow fever was sent and pending, while an ELISA IgM test for Dengue was reported as positive. A Chest x ray demonstrated mild bilateral pleural effusions, and an abdominal ultrasound showed the presence of a small amount of intraabdominal fluid. Observation in the ICU continued with the monitoring of vital signs and levels of platelets along with the administration of intravenous fluid for the next 4 days. The patient improved symptomatically, the petechial rash vanished and the gum bleeding stopped. Bedside ultrasound confirmed disappearance of pleural and intra-abdominal fluid. Results for Yellow fever test were reported as negative and the patient was transferred out of ICU to the general medical ward the following day.