In this podcast, James talks to Dr Indy Sandaradura about how to evaluate and manage a febrile returned traveller.
Fever in the returned traveller is a common presentation to Emergency Departments across Australia. Estimations suggest that febrile illness occurs in about 2-3% of travellers. Febrile illness occurs when the patient runs a temperature at 38 degrees Celsius or above. For example, returned travellers suffering a fever accounts for about a quarter of post-travel presentations for medical care.
For instance, some common causes of travel-related fever include:
However, it can be a diagnostic challenge for junior doctors to determine the cause and management of these potentially contagious patients. Hence, your best chance of accurately evaluating the patient is to take a detailed history, targeted examination and thorough evaluation.
Summary Writers: Jeff Duncan, Viola Korczak
Editor: Indy Sandaradura
Interviewee: Indy Sandaradura
Indy Sandaradura is an Infectious Diseases Physician and Clinical Microbiologist at the Centre for Infectious Diseases and Microbiology at Westmead Hospital, Sydney, and a Clinical Lecturer at the University of Sydney. He completed his medical degree in New Zealand and his specialty training in Sydney.
With Dr. Indy Sandaradura, Infectious Diseases Physician and Clinical Microbiologist, Westmead Hospital, New South Wales, Australia.
Fever in the returned traveller is a not uncommon presentation to Emergency Departments across Australia. It is estimated that febrile illness (temperature >38C) occurs in about 2-3% of travellers and accounts for about a quarter of post-travel presentations for medical care. Common causes of travel-related fever include malaria, influenza, dengue fever, rickettsial infections, non-specific viral syndromes and bacterial diarrhea. Travellers may prove a diagnostic challenge in view of the vast array of infectious and non-infectious aetiologies that require consideration, as well as the practical management of a potentially contagious patient. An accurate detailed history, targeted examination and judicious use of investigations will afford a clinician the best chance of evaluating the patient appropriately.
You are a junior doctor working in the Emergency Department and you get called to see a 21-year-old male who’s complaining of a three-day history of fever and malaise upon returning from a holiday in Malaysia.
Subsequent testing dictated by history and examination:
Typhoid or Enteric Fever
A serious complication of Typhoid is intestinal haemorrhage and micro-perforation, occurring 2-3 weeks after contracting the illness. It is easily confused with Malaria and Dengue Fever
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