XXXX in a British travel guide.

@entity1143 @entity1 @entity390 @entity294 @entity391 @entity843 @entity177 @entity854 @entity5714 @entity490 @entity382 @entity7643 @entity551 @entity221
A 44-year-old female British travel guide suddenly had @entity221 , @entity390 , @entity391 , and @entity294 develop during her stay in South India. Four days later she was transported to our hospital. At admission she had a high temperature, impaired respiration, and @entity490 . Clinical examination revealed bilateral @entity1143 , @entity382 , and @entity843 . Two days later the @entity1 showed a generalized macular rash with a conspicuous sparing of small islands of normal skin. Hemorrhagic erythema on the palms and soles as well as focal petechiae on the hard palate and scleral and conjunctival bleeding were also observed. @entity551 and @entity177 developed 1 week after the illness started. Laboratory investigations revealed highly elevated levels of hepatic enzymes, severe @entity5714 , decreased platelet counts, and @entity854 values. The presumptive clinical diagnosis of @entity7643 was supported by serologic testing that disclosed sustained high titers of hemagglutination inhibition antibodies. Symptomatic therapy with substitution of volume and albumin, blood transfusions, and administration of antipyretics resulted in complete recovery within 6 weeks.
