Fever in the Returned Traveler Flashcards
What is the most important infection to rule out in a febrile traveler who has just returned from the Tropics?
MALARIA
Fever is most commonly seen in patients returning from what region?
Subsaharan Africa
Patients returning from what regions are the following Sx most commonly seen in:
Fever NYD:
Dermatologic Sx:
Acute diarrhea
Chronic diarrhea
Fever NYD: Subsaharan Africa
Dermatologic: Caribbean and South America
Acute Diarrhea: South Asian subcontinent
Chronic Diarrhea: Central America
What are the 5 things you want to know about when approaching diagnosis in a returned traveler?
- Pre-travel prep (vaccines + malaria prophylaxis)
- trip itinerary
- epidemiology and exposure history
- history and physical exam
- lab tests according to differential diagnosis
What 5 vaccines are >90% effective?
What is the one vaccine that is 70% effective only?
> 90%:
- Yellow fever
- hep A
- hep B
- meningococcal meningitis
- Japanese encephalitis
70%:
-Typhoid
What conditions have a short incubation period (21 days)?
Short:
- Dengue (3-5 d)***
- Typhus
- bacterial enteritis
- typhoid
- HIV
- SARS
Long:
- MALARIA*** (3 wks)
- viral hepatitis
- tuberculosis
- schistosomiasis
If a patient returns from the Tropics and has been back for >7 days and has fever what can we rule out?
Dengue
3-5d incubation period
What are examples for infections resulting from the following exposures:
- Freshwater wading, flooding
- Animal bites
- sexual contact
- unpasteurized dairy
- Freshwater wading (Schistosomiasis, leptospirosis)
- Insect bites: Malaria, dengue, rickettsiosis
- Animal bites: Rabies, Herpes B
- Sexual contact: HIV, syphilis, other STIs
- Unpasteurized dairy: Brucellosis, tick-borne, encephalitis
What are the 5 main infections seen after tropical travel?
- MALARIA
- Dengue fever
- Rickettsiosis
- Typhoid
- Mononucleosis
Where do most patients diagnosed with Malaria return from?
Subsaharan Africa
Where is most Typhoid from?
Indian subcontinent
Where is most Dengue from?
Caribbean and South East Asia
Fever from the tropics is _________ until proven otherwise?
Malaria
What mosquito transmits Plasmodium spp ?
the night-biting Anopheles mosquito
What are the two most common Malaria species (these 2 kill)?
- falciparum (presents soon- KILLER)
2. vivax