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[Practical aspects on fever in returning travellers].

Ch F R Hatz1

  • 1Schweizerisches Tropeninstitut, Postfach, CH-4002 Basel. Tropmed-STI@unibas.ch

Therapeutische Umschau. Revue Therapeutique
|October 19, 2006
PubMed
Summary

Fever in returned travelers requires a broad differential diagnosis, including infectious diseases like malaria and bacterial infections. Prompt evaluation with history, examination, and basic labs is crucial for accurate diagnosis.

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Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Internal Medicine

Background:

  • Travel to tropical and sub-tropical regions presents a wide range of potential medical conditions.
  • Fever is a common symptom requiring a comprehensive differential diagnosis.

Observation:

  • Differential diagnoses include non-infectious and infectious causes, both travel-related and unrelated.
  • Key infectious differentials include bacterial meningitis, septicaemia (pyelonephritis, pneumonia), intestinal infections, amoebic liver abscess, typhoid fever, and viral hemorrhagic fevers.
  • Malaria must be excluded in patients with travel history to endemic areas within 3-12 months.

Findings:

  • A systematic approach combining thorough patient history and physical examination is essential.
  • Utilizing electronic decision support tools (e.g., fevertravel.ch) can aid in diagnosis.
  • Basic laboratory investigations (malaria blood slide, complete blood count, stool and urine cultures, serologies) are critical.

Implications:

  • Early and accurate diagnosis of fever in travelers is vital for appropriate management and preventing severe outcomes.
  • Consultation with tropical and infectious disease specialists may be necessary for complex cases.
  • This diagnostic framework supports effective clinical decision-making for febrile travelers.

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