Volume 103, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A 25-year-old medical student presented in Multan, Pakistan with a high fever, cough, myalgia, and diarrhea consistent with the typical signs and symptoms of novel coronavirus disease (COVID-19). The patient had traveled to high COVID-19–risk areas within Pakistan and had no significant medical and surgical history. Based on nasopharyngeal and oropharyngeal swab testing, the patient was found to be negative for COVID-19. He subsequently developed a diffuse rash and had serology consistent with dengue and measles. The patient was treated symptomatically, and his condition gradually improved over 7 days. This case highlights the high prevalence of many tropical diseases in low-income countries and the need for clinicians to consider alternate diagnoses in addition to testing for COVID-19 during the pandemic.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Ross R, 1901. Tropical diseases. J Am Med Assoc XXXVII: 450451.
    [Google Scholar]
  2. World Health Organization, 2019. Epidemic and pandemic-prone diseases Outbreak update – Dengue in Pakistan, 1 December 2019 [Internet]. Available at: http://www.emro.who.int/pandemic-epidemic-diseases/dengue/outbreak-update-dengue-in-pakistan-1-december-2019.html.
  3. Saba S, Khan AUR, Naeem-Ullah U, Bokhari SHM, 2019. Clinical profiles of dengue fever patients, during an outbreak. J Arthropod Borne Dis 13: 126134.
    [Google Scholar]
  4. Dietz FJ, Nieburg P, Gubler DJ, Gomez I, 1992. Diagnosis of measles by clinical case definition in dengue-endemic areas: implications for measles surveillance and control. Bull World Health Organ 70: 745750.
    [Google Scholar]
  5. Hickman CJ et al., 2011 Laboratory characterization of measles virus infection in previously vaccinated and unvaccinated individuals. J Infect Dis 204 (Suppl 1): 549558.
    [Google Scholar]
  6. Khan T, Qazi J, 2014. Measles outbreaks in Pakistan: causes of the tragedy and future implications. Epidemiol Rep 2: 1.
    [Google Scholar]

Data & Media loading...

  • Received : 25 Apr 2020
  • Accepted : 30 Apr 2020
  • Published online : 05 May 2020
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error