fever in a returning traveler

History

• travel history, fever onset, possible exposures

Physical examination

• altered mental status
• meningial signs
• abdominal tenderness
• pulmonary consolidation
• rash, cellulitis
• jaundice
• eye signs
• genital lesions

Laboratory

• complete blood count
• chemistry 14 panel
• C-reactive protein in serum
• urinalysis with microscopy & reflex culture
• blood cultures
• blood smears for malarial parasites
• save lavender top for molecular diagnostic tests
• save red top for later studies
• other specific testing as indicated

Radiology

• chest X-ray

Management

• assess qSOFA score
  • altered mental status
  • tachypnea
  • hypotension
• assess for signs of severe disease
  • cyanosis
  • meningeal signs
  • peritoneal signs
  • digital gangrene
• isolate if possibile highly contagious infection
• consider empiric antibiotics

More general terms

• fever

Additional terms

• travel medicine (traveler's health)