Fever in the returned traveler.

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.