[Practical aspects on fever in returning travellers].
Fever after travel to sub-tropical and tropical areas opens a wide door of differential diagnoses. Apart from the entire scope of internal medicine, unrelated (first manifestation of a plethora of disorders) or related to travel (e.g. pulmonary embolism in a risk patient), there are emergency and non-emergency infectious causes to be considered. Bacterial meningitis or other causes of septicaemia (Pyelonephritis, Pneumonia), severe bacterial infections of the intestines and amoebic liver abscess, typhoid fever, and viral haemorrhagic fevers should always be considered. Malaria must be ruled out if the patient has travelled in an endemic area within the past 3-12 months. A thorough history and a meticulous physical examination, the use of an electronic support (e.g. www. fevertravel.ch) and basic laboratory investigations (malaria blood slide, Hb. Differential WBC, platelets, stool culture, urine analysis, selective cultures and serologies), if necessary with the help of expert advice from a specialist in tropical and infectious diseases are elements for a successful establishment of a meaningful differential diagnosis.
Hatz
Ch F R
ChF
Schweizerisches Tropeninstitut, Postfach, CH-4002 Basel. Tropmed-STI@unibas.ch
D000328:Adult; D003937:Diagnosis, Differential; D005194:Family Practice; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008487:Medical History Taking; D010348:Patient Care Team; D012017:Referral and Consultation; D012282:Rickettsia Infections / Q000175:diagnosis; D014195:Travel; D014330:Tropical Medicine