Document 0171
 DOCN  M95A0171
 TI    Fever as the presenting complaint of travellers returning from the
       tropics.
 DT    9510
 AU    Doherty JF; Grant AD; Bryceson AD; Hospital for Tropical Diseases,
       London, UK.
 SO    QJM. 1995 Apr;88(4):277-81. Unique Identifier : AIDSLINE MED/95316461
 AB    We investigated prospectively the cause of fever in patients requiring
       hospitalization after returning from the tropics. All consecutive
       admissions (n = 195) with oral temperature > 37.0 degrees C at the time
       of admission were enrolled. Final diagnosis as recorded on the discharge
       summary by the attending physician and results of any relevant
       laboratory or radiological investigations were recorded on standard
       proforma. Malaria accounted for 42% of admissions; two patients had
       returned to Britain more than 6 months before presentation. The second
       largest group was assumed to have a non-specific viral infection (25%).
       Cosmopolitan infections (urinary tract infection, community-acquired
       pneumonia, streptococcal sore throat, etc.) accounted for 9%.
       Coincidental infections (schistosomiasis, filariasis, intestinal
       helminths) were found in 16%. Serology was positive for HIV infection in
       3%. The most useful investigation was a malaria film, which was positive
       in 45% of cases in which it was performed. The combination of
       thrombocytopaenia (platelet count < 100 x 10(9)) and hyperbilirubinaemia
       (bilirubin > 18 IU/ml) were useful predictive markers of malaria: all 23
       patients with both abnormalities had positive malaria films. Malaria
       must be excluded in any febrile patient returning from the tropics. In
       the absence of a positive malaria film, the combination of a low
       platelet count and raised bilirubin may suggest the need for an
       empirical course of therapy.
 DE    Acute Disease  Adult  Africa  Asia  Dengue/COMPLICATIONS
       Diarrhea/*COMPLICATIONS  Female  Fever/*ETIOLOGY  Great Britain  Human
       HIV Infections/COMPLICATIONS  Malaria/*COMPLICATIONS  Male  Prospective
       Studies  *Travel  *Tropical Climate  Virus Diseases/*COMPLICATIONS
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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