Fever in Returning Travelers from Tropical Regions - Frequent Differential Diagnoses Medical History: • Skin exposure to fresh or brackish water - Schistosomiasis, leptospirosis • Exposure to animals in the workplace - Leptospirosis, anthrax • Sexual contacts - HIV, herpes, hepatitis B, hepatitis C infection • Hypodermic needles - HIV, hepatitis B and C infection • Consumption of unpastuerized milk products - Brucellosis, tuberculosis, foodborne bacterial infection Cardinal Symptoms: • Fever without localizing signs or symptoms - Malaria, typhoid, rickettsioses, amebic abscess of liver, Dengue fever, HIV infection, infective endocarditis, tuberculosis, cytomegalovirus, Epstein-Barr virus infection • Maculopapular eruptions - Dengue fever, rickettsioses, typhoid, measles, relapsing fever, acute HIV infection, leptospirosis • Bleeding, petechia - Hemorrhagic fevers; Dengue virus, Crimean Congo virus, Ebola virus, Marburg virus, Lassa virus, leptospirosis • Skin ulcers (without genital lesions) - Rickettsioses, bacterial skin infection, african trypanosomiasis, plague, anthrax • Jaundice (and/or elevation of liver enzymes) - Viral hepatitis A, B, C, typhoid, yellow fever, leptospirosis, relapsing fever • Cough, dyspnea - Pneumonia (including legionellosis), tuberculosis, American histoplasmosis, melioidosis, typhoid, pulmonary embolism, malaria • Cough, dyspnea, and eosinophilia - Tropical pulmonary eosinophilia, ascariasis, strongyloidiasis, ancylostomiasis, paragonimiasis, schistosomiasis • Sore throat - Viral and bacterial pharyngitis, diphtheria, Marburg fever, Lassa fever, acute HIV infection • Abdominal pain - Typhoid, amebic liver abscess • Diarrhea - Bacterial, viral, parasitic intestinal infection, typhoid • Hepatomegaly - Viral hepatitis A, B, C, liver fluke, amebic liver abscess, visceral leishmaniasis • Splenomegaly - Visceral leishmaniasis, brucellosis, malaria, typhoid, tuberculosis, mononucleosis, infective endocarditis • Eosinophilia - Lymphatic filariasis, loasis, onchocerciasis, schistosomiasis, strongyloidiasis, ancylostomiasis, liver fluke infections, trichinosis #Fever #Returning #Traveler #differential #diagnosis #tropical #travel
