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[Fever in returned travelers]

Eyal Leshem1, Eli Schwartz

  • 1The Center for Geographic Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. leshem@gmail.com

Harefuah
|February 10, 2011
PubMed

Insights

Fever in returned travelers is common and challenging, ranging from mild to life-threatening infections. Malaria is the most frequent cause of undifferentiated fever in this group and must be ruled out.

Area of Science:

  • Infectious Diseases
  • Travel Medicine
  • Public Health

Background:

  • Fever is a frequent complaint among returned travelers, representing a significant diagnostic challenge.
  • Febrile illnesses in travelers can range from self-limiting infections to rapidly progressive, lethal diseases.
  • Differential diagnosis includes cosmopolitan and tropical infections like malaria, dengue, and enteric fever.

Purpose of the Study:

  • To outline the diagnostic approach for fever in returned travelers.
  • To highlight the importance of considering geographic origin and potential exposures.
  • To emphasize the urgent need to identify and treat life-threatening infections, particularly malaria.

Main Methods:

  • Review of common and tropical febrile illnesses in travelers.
  • Emphasis on clinical presentation, geographic exposure, and incubation periods.
  • Importance of laboratory work-up and prompt diagnosis of critical infections.

Main Results:

  • Undifferentiated fever in returned travelers is a large diagnostic group.
  • Malaria is the most common specific pathogen identified in febrile returned travelers.
  • Focal signs and symptoms aid in differential diagnosis, but undifferentiated fever requires careful evaluation.

Conclusions:

  • A systematic approach considering travel history, incubation period, and exposure is crucial.
  • Urgent evaluation for treatable, transmissible, and severe infections is paramount.
  • Malaria must be excluded in any febrile traveler returning from endemic areas.

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