Infections in Returned Travelers

Infection in the returned traveler can be challenging to evaluate in the emergency department. Diagnostic evaluation should be driven by region of travel, activities undertaken while abroad, physical examination findings (including disease severity and duration), and knowledge of the most common pathogens seen in a given area. Etiologic agents may be divided into 3 categories: diseases distributed globally, diseases that are almost exclusively imported to a given country, and disease seen domestically and internationally, although at different frequencies. Particular importance should be given to the identification of treatable etiologies (eg, malaria) and those etiologies associate with substantial morbidity and mortality, where supportive care is critical.