Management of infections in critically ill returning travellers in the intensive care unit—II: clinical syndromes and special considerations in immunocompromised patients

• One third of solid organ transplant recipients may travel to resource-limited countries within the first year post-transplant.
• Massive volume infusion is required to avoid organ failure in severe haemorrhagic fevers. A capillary leak syndrome may be the predominant manifestation of haemorrhagic fevers when volume replacement is adequate, differentiating the presentation from resource-limited countries.
• Pneumonia is the most likely cause of acute respiratory syndrome in returning travellers.

SummaryThis position paper is the second ESCMID Consensus Document on this subject and aims to provide intensivists, infectious disease specialists, and emergency physicians with a standardized approach to the management of serious travel-related infections in the intensive care unit (ICU) or the emergency department. This document is a cooperative effort between members of two European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study groups and was coordinated by Hakan Leblebicioglu and Jordi Rello for ESGITM (ESCMID Study Group for Infections in Travellers and Migrants) and ESGCIP (ESCMID Study Group for Infections in Critically Ill Patients), respectively. A relevant expert on the subject of each section prepared the first draft which was then edited and approved by additional members from both ESCMID study groups. This article summarizes considerations regarding clinical syndromes requiring ICU admission in travellers, covering immunocompromised patients.