Fever in a Returning Traveler

If a returning traveler has a fever, think malaria malaria malaria!!!

Step 1: Ask your patient if they have traveled within the last year

  • If yes… You should at least CONSIDER malaria

Step 2: If patient says yes, take a travel history

  • When did they go
  • Where did they stay
  • Where they exposed to anything concerning
    • Mosquitos
    • Animals
    • Weird foods
    • Sexual partners
    • Sick people
  • Where they in developed/tourist areas or “off the trail”

Step 3: Ask about prophylaxis

  • Did they see a doctor before leaving?
  • Did they take any immunizations or medicines prior to departure?
  • Did they continue prophylaxis as instructed?

Step 4: Go to the CDC website

  • Look up the country of concern
  • Will help establish your differential

Step 5: Test for malaria

  • If you are concerned that patient has malaria…
  • Order thick and thin blood smear

Additional Reading

2 Comments

  1. EugĂȘnio S. Ramos

    Great podcast. Another couple diseases to be aware of are Chikungunya and leishmaniasis, if they’re coming back from Latin America.

    • Zack

      Definitely!

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