Management of patients with fever during or after a travel to the tropics

Somia Iqtadar, MD, is an associate professor of medicine at King Edward Medical University, Pakistan, and chairperson of the Dengue Expert Advisory Group. Her areas of interest include cardiometabolic medicine and infectious diseases.

What management should be recommended to a patient planning a travel to the tropics in the case of fever during or after the travel? How to manage a febrile patient who has recently returned from the tropics?

Somia Iqtadar, MD: Fever during or after a travel to the tropical regions requires prompt evaluation and appropriate management of the potential risks and infections that you can encounter in that particular tropical destination. Whenever somebody experiences fever, they should immediately contact either a local doctor or, on their return, their travel medicine expert to identify the cause of that febrile illness.

In tropical regions, malaria, dengue, yellow fever, and food- and water-borne diseases like hepatitis A and typhoid [fever] are common and they should be kept in mind while evaluating the patient. But evaluation starts with a proper and thorough history regarding the travel, the destination where they went, any exposure and symptomatology, because that guides [us through] diagnostic testing and then evaluation.

The diagnostic testing may be some blood workup, it could be imaging or a pathogen-specific test related to some infections. Generally antipyretics and supportive care are given and, if required, antimicrobial therapies initiated. It is important that all travelers who experience any such disease must consult their travel medicine expert on their return so that they can be thoroughly and properly investigated and managed to avoid complications.