Recent travel with fever, headache, conjunctival injection, facial flushing followed by jaundice, black emesis, and albuminuria.

• A. Dengue Fever
• B. Lassa Fever
• C. Yellow Fever
• D. Ebola

Answer: (C)

The pattern you’re seeing centers on a classic travel-associated viral hemorrhagic fever presentation, with a strong emphasis on hepatic involvement. The sequence of fever and systemic symptoms followed by jaundice and a black vomit is highly characteristic of Yellow Fever. The liver is damaged by the infection, leading to jaundice, while GI bleeding can produce the dark, “black” vomitus. Albuminuria can occur with severe disease due to vascular leakage and organ involvement.

Other hemorrhagic fevers can cause bleeding and fever, but the combination of prominent jaundice and the distinctive black vomit after recent travel is much more typical for Yellow Fever. Dengue can cause bleeding and shock but jaundice and black vomit are less characteristic; Ebola and Lassa may present with hemorrhage as well, but their hallmark patterns and exposure histories differ, making Yellow Fever the best fit for this vignette.