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Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management.
J Infect. 2009 Jul; 59(1):1-18.JI

Abstract

International travel is increasing. Most physicians and general practitioners will encounter returned travellers with fever and the majority of travel-related infection is associated with travel to the tropics. In those returning from the tropics malaria must always be excluded, and HIV considered, from all settings. Common causes of non-malarial fever include from Africa rickettsial diseases, amoebic liver abscess and Katayama syndrome; from South and South East Asia, enteric fever and arboviral infection; from the Middle East, brucellosis and from the Horn of Africa visceral leishmaniasis. Other rare but important diseases from particular geographical areas include leptospirosis, trypanosomiasis and viral haemorrhagic fever. North and South America, Europe and Australia also have infections which are geographically concentrated. Empirical treatment may have to be started based on epidemiological probability of infection whilst waiting for results to return. The evidence base for much of the management of tropical infections is limited. These recommendations provide a pragmatic approach to the initial diagnosis and management of fever in returned travellers, based on evidence where it is available and on consensus of expert opinion where it is not. With early diagnosis and treatment the majority of patients with a potentially fatal infection related to travel will make a rapid and full recovery.

Authors+Show Affiliations

Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London, UK. victoria.johnston@lshtm.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

19595360

Citation

Johnston, Victoria, et al. "Fever in Returned Travellers Presenting in the United Kingdom: Recommendations for Investigation and Initial Management." The Journal of Infection, vol. 59, no. 1, 2009, pp. 1-18.
Johnston V, Stockley JM, Dockrell D, et al. Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management. J Infect. 2009;59(1):1-18.
Johnston, V., Stockley, J. M., Dockrell, D., Warrell, D., Bailey, R., Pasvol, G., Klein, J., Ustianowski, A., Jones, M., Beeching, N. J., Brown, M., Chapman, A. L., Sanderson, F., & Whitty, C. J. (2009). Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management. The Journal of Infection, 59(1), 1-18. https://doi.org/10.1016/j.jinf.2009.05.005
Johnston V, et al. Fever in Returned Travellers Presenting in the United Kingdom: Recommendations for Investigation and Initial Management. J Infect. 2009;59(1):1-18. PubMed PMID: 19595360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management. AU - Johnston,Victoria, AU - Stockley,Jane M, AU - Dockrell,David, AU - Warrell,David, AU - Bailey,Robin, AU - Pasvol,Geoffrey, AU - Klein,John, AU - Ustianowski,Andrew, AU - Jones,Michael, AU - Beeching,Nicholas J, AU - Brown,Michael, AU - Chapman,Ann L N, AU - Sanderson,Frances, AU - Whitty,Christopher J M, AU - ,, Y1 - 2009/05/27/ PY - 2009/05/15/received PY - 2009/05/20/accepted PY - 2009/7/15/entrez PY - 2009/7/15/pubmed PY - 2009/8/29/medline SP - 1 EP - 18 JF - The Journal of infection JO - J Infect VL - 59 IS - 1 N2 - International travel is increasing. Most physicians and general practitioners will encounter returned travellers with fever and the majority of travel-related infection is associated with travel to the tropics. In those returning from the tropics malaria must always be excluded, and HIV considered, from all settings. Common causes of non-malarial fever include from Africa rickettsial diseases, amoebic liver abscess and Katayama syndrome; from South and South East Asia, enteric fever and arboviral infection; from the Middle East, brucellosis and from the Horn of Africa visceral leishmaniasis. Other rare but important diseases from particular geographical areas include leptospirosis, trypanosomiasis and viral haemorrhagic fever. North and South America, Europe and Australia also have infections which are geographically concentrated. Empirical treatment may have to be started based on epidemiological probability of infection whilst waiting for results to return. The evidence base for much of the management of tropical infections is limited. These recommendations provide a pragmatic approach to the initial diagnosis and management of fever in returned travellers, based on evidence where it is available and on consensus of expert opinion where it is not. With early diagnosis and treatment the majority of patients with a potentially fatal infection related to travel will make a rapid and full recovery. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/19595360/Fever_in_returned_travellers_presenting_in_the_United_Kingdom:_recommendations_for_investigation_and_initial_management_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(09)00154-6 DB - PRIME DP - Unbound Medicine ER -