Fever in Returning Travelers from Tropical Regions - Frequent Differential Diagnoses

Medical History:

 • Skin exposure to fresh or brackish water - Schistosomiasis, leptospirosis

 • Exposure to animals in the workplace - Leptospirosis, anthrax

 • Sexual contacts - HIV, herpes, hepatitis B, hepatitis C infection

 • Hypodermic needles - HIV, hepatitis B and C infection

 • Consumption of unpastuerized milk products - Brucellosis, tuberculosis, foodborne bacterial infection

Cardinal Symptoms:

 • Fever without localizing signs or symptoms - Malaria, typhoid, rickettsioses, amebic abscess of liver, Dengue fever, HIV infection, infective endocarditis, tuberculosis, cytomegalovirus, Epstein-Barr virus infection

 • Maculopapular eruptions - Dengue fever, rickettsioses, typhoid, measles, relapsing fever, acute HIV infection, leptospirosis

 • Bleeding, petechia - Hemorrhagic fevers; Dengue virus, Crimean Congo virus, Ebola virus, Marburg virus, Lassa virus, leptospirosis

 • Skin ulcers (without genital lesions) - Rickettsioses, bacterial skin infection, african trypanosomiasis, plague, anthrax

 • Jaundice (and/or elevation of liver enzymes) - Viral hepatitis A, B, C, typhoid, yellow fever, leptospirosis, relapsing fever

 • Cough, dyspnea - Pneumonia (including legionellosis), tuberculosis, American histoplasmosis, melioidosis, typhoid, pulmonary embolism, malaria

 • Cough, dyspnea, and eosinophilia - Tropical pulmonary eosinophilia, ascariasis, strongyloidiasis, ancylostomiasis, paragonimiasis, schistosomiasis

 • Sore throat - Viral and bacterial pharyngitis, diphtheria, Marburg fever, Lassa fever, acute HIV infection

 • Abdominal pain - Typhoid, amebic liver abscess

 • Diarrhea - Bacterial, viral, parasitic intestinal infection, typhoid

 • Hepatomegaly - Viral hepatitis A, B, C, liver fluke, amebic liver abscess, visceral leishmaniasis

 • Splenomegaly - Visceral leishmaniasis, brucellosis, malaria, typhoid, tuberculosis, mononucleosis, infective endocarditis

 • Eosinophilia - Lymphatic filariasis, loasis, onchocerciasis, schistosomiasis, strongyloidiasis, ancylostomiasis, liver fluke infections, trichinosis



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