Returning traveller Flashcards
What are differential diagnoses for fever in returning traveller?
<21 days since returning
Leptospirosis Neisseria Meningitidis Typhoid Tyhpus - rickettsia Plague Melioidosis
JE YF Dengue Chikungunya VHF
African Trypanosomiasis
Malaria
What are differential diagnoses for fever in returning traveller?
> 21 days since returning
Amoebic liver abscess
Relapsing fever - borreliosis
Brucellosis
TB
HIV - acute
Rabies
Viral hepatitis - A/B/C/E
Leishmaniasis
African Trypanosomiasis
Malaria - consider up to 1 year
Schistosomiasis
Filariasis
What are important parts of a travel history?
Dates and timing onset symptoms
travel destination - rural/ urban
accommodation - hotel/ camping
purpose of travel - mass gathering e.g pilgrimage
contact with unwell people
food consumed - unpasteurised dairy, raw meat/ fish, bush food
contact with animals - caves, wet market, game parks
tick/ spider/ insect bites
water exposure - paddy fields, swimming, fresh/ salt water
use of local health facility e.g risk from transfusion, CRE
risky behaviour - sex/ IVDU
prophylaxis/ vaccinations
What are routine baseline investigations for returning traveller?
FBC U+Es LFTs CRP Coag
Blood culture Malaria rapid antigen test Thick/ thin blood film Bloods for storage HIV
Urinalysis
stool - MCS, OCP
CXR
What are differential diagnoses for returning traveller with following clinical findings -
rash - maculopapular
Viral - Arbovirus - dengue, chikungunya HIV EBV CMV rubella parvovirus
Bacterial -
Typhoid - Rose spots
Secondary syphilis
rickettsia
Protozoal
schistosomiasis - Katayama fever
What are differential diagnoses for returning traveller with following clinical findings -
rash - petechial
VHF
dengue
leptospirosis
meningococcus
What are differential diagnoses for returning traveller with following clinical findings -
eschar
scrub typhus/ tick typhus
ecythma gangrenosum - pseudomonas
anthrax
cutaneous yersinia pestis
fungal - dimorphic fungi/ mucormycosis
brown recluse spider bite
What are differential diagnoses for returning traveller with following clinical findings -
jaundice
malaria
viral hepatitis
VHF
Dengue - haemorrhagic fever
YF
leptospirosis
What are differential diagnoses for returning traveller with following clinical findings -
hepatomegaly
viral hepatitis
malaria
liver abscess
leptospirosis
brucellosis
leishmaniasis
What are differential diagnoses for returning traveller with following clinical findings -
splenomegaly
malaria
leishmaniasis
trypanosomiasis
brucellosis
Returning traveller unwell following tick bite
what are differential diagnoses
spotted fevers - tick typhus, RMSF
lyme disease
TBE
CCHF
tularaemia
babesiosis
Returning traveller unwell following mosquito bite
what are differential diagnoses
malaria
arbovirus - YF, dengue, WNV, zika, chikungunya, JE
filariasis
Returning traveller unwell with diarrhoeal illness
what are differential diagnoses
shigella salmonella viral gastroenteritis giardia cryptosporidium strongyloides
Returning traveller unwell following fly bite
what are differential diagnoses
African trypanosomiasis
onchocerciasis
leishmaniasis
loa loa
sandfly fever
Pre-travel risk assessment.
What vaccines might be recommended?
MMR Diptheria Tetanus Polio BCG
Meningitis ACWY YF Cholera HAV HBV JE Rabies TBE Typhoid
