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


  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


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