Fever in the returned traveller

The diagnosis of fever in the returned traveller is an important challenge to the physician. An accurate travel history and knowledge of the incubation period of common diseases is required to assess the risk of infection with a specific infectious agent. Although many febrile illnesses are benign and self-limiting, failure to diagnose malaria and enteric fevers may have disastrous consequences. All patients returning with fever should have thick and thin blood films for malaria and blood cultures performed. Other haematological and biochemical tests are useful in identifying a group of patients in whom empirical anti-microbial therapy is indicated. Thought must be given to the isolation of patients and notification of certain suspected or proven diseases to the local Consultant for Communicable Disease Control. Preventative measures in those likely to travel again should be discussed.