travel

Fever in the returning traveller

Abstract

Travel-related infections are becoming more common as travel abroad becomes easier. Whilst most imported infections will have recognisable features some of the more obscure will be less familiar to the clinician. A detailed travel history including all stopovers is vital as is a thorough examination. Falciparum malaria is a medical emergency and prompt treatment is essential. Emerging infections such as SARS and avian influenza provide new challenges in diagnosis for the admitting team.

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Fever in the returned traveller

Abstract

The diagnosis of fever in the returned traveller is an important challenge to the physician. An accurate travel history and knowledge of the incubation period of common diseases is required to assess the risk of infection with a specific infectious agent. Although many febrile illnesses are benign and self-limiting, failure to diagnose malaria and enteric fevers may have disastrous consequences. All patients returning with fever should have thick and thin blood films for malaria and blood cultures performed. Other haematological and biochemical tests are useful in identifying a group of patients in whom empirical anti-microbial therapy is indicated. Thought must be given to the isolation of patients and notification of certain suspected or proven diseases to the local Consultant for Communicable Disease Control. Preventative measures in those likely to travel again should be discussed.

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