Missed Opportunities for Timely Diagnosis and Effective Therapeutic Management of Prolonged Fever: A Case Study of Confirmed Lassa Fever in N'Zérékoré, Guinea, 2022.

BACKGROUND

Lassa fever is a potentially fatal viral hemorrhagic disease caused by a ribonucleic acid (RNA) virus of the Arenaviridae family, endemic in West Africa. It is highly virulent and contagious in several countries, with a nonspecific clinical presentation that poses a major public health challenge. An in-depth investigative survey was conducted in N'Zérékoré to identify the transmission chain of a confirmed case of Lassa fever.

CASE PRESENTATION: This study reports a confirmed case of Lassa fever diagnosed 13 days after the onset of persistent fever. The disease was suspected at the regional hospital of N'Zérékoré following the worsening of the initial clinical picture, characterized by the onset of hemorrhagic manifestations and failure of antibiotic therapy. Confirmation of Lassa virus infection by reverse transcriptase-polymerase chain reaction (RT-PCR) on a blood sample was obtained a day prior to the patient's death. The patient did not receive ribavirin treatment and remained on the same antibiotic regimen (ceftriaxone) from the onset of fever, combined with dexamethasone, omeprazole, and a unit of blood transfusion.

CONCLUSION

The therapeutic pathway of this confirmed Lassa fever case in N'Zérékoré highlights the need for improved management of viral hemorrhagic fevers and consideration of differential diagnoses when broad-spectrum antibiotic therapy fails.