Undifferentiated febrile illnesses in South Sudan: A case series from Operation TRENTON from June to August 2017

Jason S. Biswas*, J. Lentaigne, D. S. Burns, J. C. Osborne, A. J. Simpson, E. J. Hutley, N. E. Hill, M. S. Bailey

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)


Undifferentiated febrile illnesses present diagnostic and treatment challenges in the Firm Base, let alone in the deployed austere environment. We report a series of 14 cases from Operation TRENTON in South Sudan in 2017 that coincided with the rainy season, increased insect numbers and a Relief in Place. The majority of patients had headaches, myalgia, arthralgia and back pain, as well as leucopenia and thrombocytopenia. No diagnoses could be made in theatre, despite a sophisticated deployed laboratory being available, and further testing in the UK, including next-generation sequencing, was unable to establish an aetiology. Such illnesses are very likely to present in tropical environments, where increasing numbers of military personnel are being deployed, and clinicians must be aware of the non-specific presentation and treatment, as well as the availability of Military Infection Reachback services to assist in the management of these cases.

Original languageEnglish
Pages (from-to)358-361
Number of pages4
JournalBMJ Military Health
Issue number5
Early online date23 Sept 2020
Publication statusPublished - 27 Sept 2021

Bibliographical note

Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Open Access: No Open Access licence.

Publisher Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation: Biswas JS, Lentaigne J, Burns DS, et al. Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017. BMJ Mil Health. 2021;167:358-361.

DOI: http://dx.doi.org/10.1136/jramc-2019-001238


  • South Sudan
  • disease and non-battle injuries
  • fever of unknown origin
  • military personnel


Dive into the research topics of 'Undifferentiated febrile illnesses in South Sudan: A case series from Operation TRENTON from June to August 2017'. Together they form a unique fingerprint.

Cite this