42-year-old gentleman, came to us with day 6 fever, associated with poor appetite, lethargic. He has no know medical illness.
On further questioning, he has history of hiking to Bengoh 2 weeks ago and to Matang a week ago.
On examination, he has no jaundice, hydration fair with BP 120/70, HR93/min, no baseline. He is a regular cyclist.
Blood test was done and result as below:
He was referred to hospital immediately, and further workout done showed acute renal impairment with creatinine level at 300Umol/L.
Patient recovered uneventfully after days of admission.