title: Management of travelers with fever and exanthema, notably dengue and chikungunya infections.
abstract: Febrile exanthema frequently presents as an acute condition in travelers. Sixty-two travelers who presented with febrile exanthema were prospectively included over a 20-month period. Diagnostic tests were performed according to clinical presentation and risk exposures. Symptoms occurred after return in 56% of these travelers, and the median interval between return and symptom onset was 2 days. The 3 main travel destinations were the Indian Ocean (35%), Africa (21%), and Asia (18%). The 3 main etiologies were chikungunya (35%), dengue (26%), and African tick bite fever (ATBF) (10%). Travel to the Indian Ocean and South Africa was significantly associated with respectively chikungunya and ATBF. Arthralgias were significantly more frequent in chikungunya than in dengue, whereas leucopenia, neutropenia, and thrombopenia were significantly more frequent in dengue. Travelers presenting with febrile exanthema should therefore be screened for arboviral infections according to the area visited.
authors.affiliation: Department of Infectious and Tropical Disease, Hôpital Pitié-Salpêtrière, Paris, France. p.hochedez@free.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Hochedez
authors.forename: Ana
authors.initials: A
authors.lastname: Canestri
authors.forename: Amélie
authors.initials: A
authors.lastname: Guihot
authors.forename: Ségolène
authors.initials: S
authors.lastname: Brichler
authors.forename: François
authors.initials: F
authors.lastname: Bricaire
authors.forename: Eric
authors.initials: E
authors.lastname: Caumes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018354:Alphavirus Infections / Q000175:diagnosis*; D001424:Bacterial Infections / Q000175:diagnosis*; D002646:Chikungunya virus; D003715:Dengue / Q000175:diagnosis*; D005260:Female; D005334:Fever / Q000209:etiology*; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel; D014329:Tropical Climate; D014777:Virus Diseases / Q000175:diagnosis*