[Sandfly fever-a "neglected" disease]

Area of Science:

• Tropical Medicine
• Virology
• Epidemiology

Background:

• Sandfly fever, caused by phleboviruses, is transmitted by sandflies and prevalent in Mediterranean regions.
• Clinical presentation can include fever, rash, and hepatitis, mimicking other febrile illnesses.
• Differential diagnosis in travelers returning from endemic areas is crucial.

Observation:

• A traveler returning from northern Cyprus presented with fever, rash, diarrhea, and elevated liver enzymes.
• Exposure to biting insects, likely sandflies, was reported in the endemic area.
• Clinical presentation suggested sandfly fever, prompting serological testing.

Findings:

• Antibodies to sandfly fever Sicilian virus (SFSV) were detected, confirming the diagnosis of pappataci fever.
• The patient's clinical course and antibody dynamics were consistent with SFSV infection.
• Elevated transaminases and C-reactive protein indicated systemic inflammation and liver involvement.

Implications:

• This case highlights the importance of considering phlebovirus infections, such as SFSV, in travelers presenting with hepatitis and rash.
• Prompt recognition and diagnosis of pappataci fever are essential for managing potential complications.
• Increased awareness among clinicians can improve the diagnosis of imported viral diseases in returning travelers and refugees.