Fever in returned travelers: Review of hospital admissions for a 3-year period

We reviewed 232 consecutive patients admitted to a tertiary-care hospital u nder the care of an infectious diseases unit for management of febrile illn ess acquired overseas. A total of 53% presented to hospital within 1 week o f return and 96% within 6 months. Malaria was the most common diagnosis (27 % of patients), followed by respiratory tract infection (24%), gastroenteri tis (14%), dengue fever (8%), and bacterial pneumonia (6%). Pretravel vacci nation may have prevented a number of admissions, including influenza (n = 11), typhoid fever (n = 8) and hepatitis A (n = 6). Compared to those who h ad not traveled to Africa, those who had were 6 times more likely to presen t with falciparum than nonfalciparum malaria. An itinerary that included As ia was associated with a 13-fold increased risk of dengue, but a lower risk of malaria. Palpable splenomegaly was associated with an 8-fold risk of ma laria and hepatomegaly with a 4-fold risk of malaria. As a cause of fever, bacterial pneumonia was greater than or equal to5 times more likely in thos e who were aged >40 years.