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Fever in the returned traveler

Vincent Lo Re1, Stephen J Gluckman

  • 1Division of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. vincent.lore@uphs.upenn.edu

American Family Physician
|October 22, 2003
PubMed

Insights

Fever in returned travelers can signal serious tropical infections, not just common illnesses. Prompt medical evaluation including travel history is crucial for accurate diagnosis and timely treatment.

Area of Science:

  • Tropical Medicine
  • Travel Medicine
  • Infectious Diseases

Background:

  • International travel to exotic locations is increasing.
  • Family physicians frequently encounter febrile patients returning from tropical regions.
  • While common infections cause fever in most returned travelers, severe tropical diseases must be considered.

Purpose of the Study:

  • To highlight the importance of considering tropical infections in febrile returned travelers.
  • To outline key historical and clinical factors for diagnosis.
  • To provide guidance on initial management of specific tropical diseases.

Main Methods:

  • Review of clinical presentations and diagnostic considerations for febrile returned travelers.
  • Emphasis on detailed patient history, including travel, accommodations, immunizations, sexual history, and exposures.
  • Discussion of diagnostic clues such as lymphadenopathy and altered mental status.

Main Results:

  • Fever in returned travelers necessitates suspicion for severe or life-threatening tropical infections.
  • Malaria must be considered even with brief travel to endemic areas.
  • Specific treatments are recommended for common tropical infections like enteric fever, dengue fever, leptospirosis, and rickettsial infections.

Conclusions:

  • A thorough travel history is essential for diagnosing febrile patients returning from the tropics.
  • Altered mental status in a febrile traveler is an alarming symptom requiring urgent assessment.
  • Prompt and accurate diagnosis of tropical infections can prevent severe outcomes.

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