Evaluating a sick child after travel to developing countries.

September 26, 2011 at 12:52 am Leave a comment

J Am Board Fam Med. 2010 Nov-Dec;23(6):704-13.

Tolle MA.

Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.tolle@bcm.edu


Every year, millions of children travel internationally with their families, many to developing countries. Although the vast majority experience uneventful travel and return home well, it is not uncommon for children to present as ill during or after travel. Although the majority of travel-associated illness is mild and self-limited, serious conditions regularly occur. Almost all life-threatening conditions after travel present with fever, and malaria is the most important of these to rapidly exclude. Gastrointestinal symptoms are common after travel in the developing world, and most diarrhea in child travelers has a bacterial
source. Children who have a rash in association with fever or who appear ill should receive a priority work-up focused on ruling out serious conditions. Many children traveling internationally experience respiratory illness during or shortly after travel, mainly common upper respiratory infections, yet serious conditions, such as tuberculosis, may occur. Eosinophilia is common in the returned pediatric traveler, particularly those with prolonged stays in the tropics. Not all eosinophilia is caused by parasitic infection; drug reactions, asthma, and other allergic conditions are also common causes. With a focus first on ruling out life-threatening disease and subsequently on an informed and efficient path to diagnosis and treatment, clinicians may confidently
provide care for this challenging group of patients.





Entry filed under: Epidemiología, Infecciones gastrointestinales, Infecciones respiratorias, Medicina del viajero, Micobacterias.

Rickettsia typhi infection with interstitial pneumonia in a traveler treated with moxifloxacin. Fever in returned travelers: results from the GeoSentinel Surveillance Network.

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