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Published on: February 23, 2014
[Infections of the lungs in returning travellers]
1Medizinische Klinik m. S. Infektiologie und Pneumologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Deutschland.
Abstract:
Travellers to foreign countries can acquire infections with pathogens that are not endemic in Germany. In light of the steadily increasing foreign travel these infections in returning travellers are of growing importance. Older travellers and those with underlying diseases constitute a special risk group. The knowledge of pathogens endemic to foreign countries and of the respective clinical picture is essential for determining a suspected diagnosis, especially in patients not responding to a first empirical antibacterial treatment. The documentation of a thorough travel history is crucial for taking a possible exposure to specific pathogens into account and thus for guiding the diagnostic pathway. In addition to pathogens which primarily lead to an infection of the lungs, non-pulmonary infections, which can cause pulmonary symptoms, e.g. schistosomiasis and malaria also have to be considered. Two examples of infectious diseases of the lungs, which can only be acquired abroad, are melioidosis and coccidioidomycosis. While a pulmonary manifestation of melioidosis can take an acute and fulminant course associated with a high mortality rate, coccidioidomycosis primarily presents mostly as oligosymptomatic, but with a substantial latent period can lead to pulmonary manifestations that in their diversity resemble tuberculosis or malignancies.
Insights
Returning travelers can contract foreign infections, posing risks especially to older individuals and those with pre-existing conditions. Accurate travel history is vital for diagnosing these tropical diseases.
Area of Science:
- Tropical medicine
- Infectious diseases
- Public health
Context:
- Increasing international travel leads to a rise in imported infections among returning travelers.
- Older travelers and those with chronic illnesses represent a high-risk group for severe outcomes.
- Diagnosing infections acquired abroad requires knowledge of endemic pathogens and clinical presentations.
Purpose:
- To highlight the importance of recognizing and diagnosing infections acquired during foreign travel.
- To emphasize the role of travel history in identifying potential exposures to exotic pathogens.
- To discuss specific infectious diseases like melioidosis and coccidioidomycosis acquired abroad.
Summary:
- Infections acquired during international travel are a growing concern, particularly for vulnerable populations.
- A detailed travel history is crucial for accurate diagnosis, especially when initial treatments fail.
- Non-pulmonary infections (e.g., schistosomiasis, malaria) and pulmonary infections (e.g., melioidosis, coccidioidomycosis) acquired abroad must be considered.
Impact:
- Improved diagnostic accuracy for imported infections, leading to timely and appropriate treatment.
- Enhanced clinical awareness of travel-related diseases among healthcare providers.
- Better management strategies for infectious diseases in travelers, reducing morbidity and mortality.
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