Fever in traveler: Difference between revisions
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=General= | ==General== | ||
*If incubation period >1 month: dengue, rickettsia, viral hemorrhagic fever less likely | *If incubation period >1 month: dengue, rickettsia, viral hemorrhagic fever less likely | ||
*CBC with differential; thick smear; liver function tests; urinalysis; blood & stool cultures; chest x-ray; serologies for specific viruses | *CBC with differential; thick smear; liver function tests; urinalysis; blood & stool cultures; chest x-ray; serologies for specific viruses | ||
=Differential Diagnosis= | ==Differential Diagnosis== | ||
*[[Malaria]] | *[[Malaria]] | ||
*[[Dengue]] | *[[Dengue]] | ||
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*[[Hemorrhagic Fevers]] | *[[Hemorrhagic Fevers]] | ||
=Fever + CNS Changes= | ==Fever + CNS Changes== | ||
*malaria, tuberculosis, typhoid fever, rickettsia, poliomyelitis, rabies, viral (Japanese/ West Nile/ tick borne) encephalitis | *malaria, tuberculosis, typhoid fever, rickettsia, poliomyelitis, rabies, viral (Japanese/ West Nile/ tick borne) encephalitis | ||
*meningococcal meningitis associated with Haj to Mecca | *meningococcal meningitis associated with Haj to Mecca | ||
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*trypanosomiasis by tsetse fly = Africal sleeping sickness = red chancre at site of fly bite, fever, headache, myalgias proceding to meningoencephalitis. May see trypansosomes in smear in acute phase | *trypanosomiasis by tsetse fly = Africal sleeping sickness = red chancre at site of fly bite, fever, headache, myalgias proceding to meningoencephalitis. May see trypansosomes in smear in acute phase | ||
=Fever + Respiratory Symptoms= | ==Fever + Respiratory Symptoms== | ||
*streptococcal pneumonia, influenza, mycoplasma, legionella, tuberculosis | *streptococcal pneumonia, influenza, mycoplasma, legionella, tuberculosis | ||
*Q fever: ''coxiella burnetti'': fever, pneumonia, hepatitis after animal exposure | *Q fever: ''coxiella burnetti'': fever, pneumonia, hepatitis after animal exposure | ||
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*cough also seen in malaria, typhoid fever, scrub typhus, dengue | *cough also seen in malaria, typhoid fever, scrub typhus, dengue | ||
=Sexually Transmitted / Blood Exposure and Fever= | ==Sexually Transmitted / Blood Exposure and Fever== | ||
*can have fever without genital findings: HIV, syphilis (''Treponema pallidum'') cytomegalovirus (CMV), Epstein-Barr Virus (EBV), hepatitis B | *can have fever without genital findings: HIV, syphilis (''Treponema pallidum'') cytomegalovirus (CMV), Epstein-Barr Virus (EBV), hepatitis B | ||
*also from tattoos, piercings, share razor, blood transfusion | *also from tattoos, piercings, share razor, blood transfusion | ||
=See Also= | ==See Also== | ||
[[Travel Medicine]] | [[Travel Medicine]] | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:TropMed]] | [[Category:TropMed]] | ||
Revision as of 20:30, 26 March 2014
General
- If incubation period >1 month: dengue, rickettsia, viral hemorrhagic fever less likely
- CBC with differential; thick smear; liver function tests; urinalysis; blood & stool cultures; chest x-ray; serologies for specific viruses
Differential Diagnosis
Fever + CNS Changes
- malaria, tuberculosis, typhoid fever, rickettsia, poliomyelitis, rabies, viral (Japanese/ West Nile/ tick borne) encephalitis
- meningococcal meningitis associated with Haj to Mecca
- eosinophilic meningitis associated with coccidiomycosis or angiostrongyliasis (rat lung worm to brain)
- trypanosomiasis by tsetse fly = Africal sleeping sickness = red chancre at site of fly bite, fever, headache, myalgias proceding to meningoencephalitis. May see trypansosomes in smear in acute phase
Fever + Respiratory Symptoms
- streptococcal pneumonia, influenza, mycoplasma, legionella, tuberculosis
- Q fever: coxiella burnetti: fever, pneumonia, hepatitis after animal exposure
- Loffler's syndrome: pulmonary infiltrates, eosinophilia from transient migration of larval helminthes through lungs
- cough also seen in malaria, typhoid fever, scrub typhus, dengue
Sexually Transmitted / Blood Exposure and Fever
- can have fever without genital findings: HIV, syphilis (Treponema pallidum) cytomegalovirus (CMV), Epstein-Barr Virus (EBV), hepatitis B
- also from tattoos, piercings, share razor, blood transfusion