Topics Discussed: foreign travel; foreign travel problem; infectious diseases; travel; traveler's diarrhea.
Sections: Imported Diseases/Diseases in the Traveling Child: Introduction, Immunizations and Chemoprophylaxis, Travel Locations, Incubation Periods, Sources of Information for International Travel-Related Diseases, Risk Factors, Physical Examination, Diagnostic Studies/Laboratory Investigations, Specific Diseases of Importance, References.
- Nonspecific viral illness is the most common final diagnosis in pediatric patients admitted to the hospital with febrile illnesses after traveling.
- Blood cultures and thin and thick smears for malaria are important initial tests for all travelers returning from an area endemic for malaria. If the first smears are negative and the diagnosis is not established, repeat smears should be obtained every 8 to 24 hours until it is certain that malaria is not the cause of the fever.
- Anemia is common in many diseases but hemoconcentration, especially in combination with thrombocytopenia, may indicate dengue fever.
- Eosinophilia is defined as a peripheral eosinophil count of > 400 to 500 cells/mm3. In the returning traveler, especially if fever is noted, helminth infection is suggested.
- Malaria most commonly presents as a nonspecific influenza-like syndrome with high fever, chills, rigors, sweats, and headache and is frequently misdiagnosed as a viral syndrome. These symptoms are unreliable in clinical practice and no combination of fever pattern, duration of symptoms, or physical findings can reliably rule out malaria.
- The laboratory diagnosis of malaria has not changed markedly over the past century. The use of thick and thin peripheral blood smears using Giemsa stain remains the "accepted diagnostic technique for malaria."
- The most practical approach in the emergency department is to..."
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