Professional Documents
Culture Documents
David O. Freedman, M.D., Leisa H. Weld, Ph.D., Phyllis E. Kozarsky, M.D., Tamara
Fisk, M.D., Rachel Robins, M.D., Frank von Sonnenburg, M.D., Jay S. Keystone, M.D.,
Prativa Pandey, M.D. and Martin S. Cetron, M.D.
N Engl J Med
Volume 354;2:119-130
January 12, 2006
Study Overview
2007 Infectious Diseases Society of America Wilson M E et al. Clin Infect Dis. 2007;44:1560-1568
Common Dermatologic Lesions in Travelers Returning from Developing Countries.
Compliance
Eating, drinking?
Bites?
Sex?
Systemic illness
fever or exanthem
Organ-specific illness
diarrhea, jaundice, or hepatosplenomegaly
Respiratory
Cardiovascular
Gastrointestinal
the sound of horses hooves..
but horses are far more comonright?
Consider non-travel conditions
Dont miss the obvious
Dont forget - routine
Pneumonia
UTI
Typical incubation periods for selected tropical infections
Geographic risks
4 major syndromes
Fever
Diarrhoea
Eosinophilia
Rash
Fever
Malaria most important
Typhoid
Arbovirus dengue more likely outside Africa
Hepatitis A
Bacterial infections
Rickettsia
Respiratory
Cardiovascular
Gastrointestinal
Laboratory investigations
Hb 10.5 Urea 4
MCV 76 Na 135
WCC 7.2 K 3.6
Neutrophils 6.2 Creatine 98
Lymph 1.0
Platelets 57 Bili 45
ESR 50
CRP 35
Reassess our differential dx
Now consider diagnostic tests and treatments