Fever in the Returning Traveler - History Exposure History: • Street foods / Local water: entenc fever, travellers' diarrhea • Arthropod bites: malaria, dengue, chikungunya, arboviruses, Rickettsia, African trypanosomiasis • Uncooked meat / unpasteurized dairy: trichinosis, brucellosis, toxoplasmosis • Blood and body fluid exposure: sexual encounters, tattoos, piercings, injections including immunizations, intravenous (IV) drug use, and rabies post-exposure prophylaxis (PEP) (human immunodeficiency virus [HIV], HBV, hepatitis C virus [HCV], herpes simplex virus [HSV], syphilis, gonorrhea (gonococcus) / Chlamydia trachomatis [GC/CT]) • Fresh water activities: swimming, kayaking, rafting (schistosomiasis, leptospirosis • Animal exposures: Q-fever, brucellosis, tularemia, anthrax, rabies, Crimean-Congo hemorrhagic fever Fever Duration: < 7 days: malaria, travellers' diarrhea, dengue, enteric fever, RTI 7-21 days: malaria, enteric fever > 21 days: malaria, enteric fever Fever Pattern: • Daily / Continuous: malaria, travellers' diarrhea, RTI, enteric fever • Saddleback (biphasic): malaria, dengue • Relapsing: malaria, entenc fever Andrea Boggild, MD @BoggildLab #Fever #Returning #Traveler #History #diagnosis #differential
