Serious waterborne and wilderness infections

Environmentally acquired infections can be caused by animal contact, insect vectors, or contaminated water. Obtaining an appropriately detailed histor y is important in defining the differential diagnosis of possible infectiou s diseases from the wilderness. Common clinical presentations include fever with or without shock, lymphadenopathy or rash, altered mental status, dia rrhea, and pneumonia. Diagnosis often depends on obtaining blood or body fl uid for serology or culture. Antimicrobial treatment requires specific diag nosis for optimal response.