title: Fever in returned travelers: review of hospital admissions for a 3-year period.
abstract: We reviewed 232 consecutive patients admitted to a tertiary-care hospital under the care of an infectious diseases unit for management of febrile illness acquired overseas. A total of 53% presented to hospital within 1 week of return and 96% within 6 months. Malaria was the most common diagnosis (27% of patients), followed by respiratory tract infection (24%), gastroenteritis (14%), dengue fever (8%), and bacterial pneumonia (6%). Pretravel vaccination may have prevented a number of admissions, including influenza (n=11), typhoid fever (n=8) and hepatitis A (n=6). Compared to those who had not traveled to Africa, those who had were 6 times more likely to present with falciparum than nonfalciparum malaria. An itinerary that included Asia was associated with a 13-fold increased risk of dengue, but a lower risk of malaria. Palpable splenomegaly was associated with an 8-fold risk of malaria and hepatomegaly with a 4-fold risk of malaria. As a cause of fever, bacterial pneumonia was > or =5 times more likely in those who were aged >40 years.
authors.affiliation: Victorian Infectious Diseases Service, Royal Melbourne Hospital, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: O'Brien
authors.forename: S
authors.initials: S
authors.lastname: Tobin
authors.forename: G V
authors.initials: GV
authors.lastname: Brown
authors.forename: J
authors.initials: J
authors.lastname: Torresi
mesh_terms: D000328:Adult; D000349:Africa; D001208:Asia; D001428:Bacterial Vaccines / Q000008:administration & dosage; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003906:Developing Countries; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology*; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D017780:Malaria Vaccines / Q000008:administration & dosage; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014195:Travel; D014435:Typhoid Fever / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014739:Victoria / Q000453:epidemiology; D014765:Viral Vaccines / Q000008:administration & dosage
chemical_list: D001428:Bacterial Vaccines; D017780:Malaria Vaccines; D014765:Viral Vaccines