Liver disease in the traveller

Liver disease in the returning traveller can present as an illness with jaundice or liver abscess. A full travel history with details of potential exposures is crucial to making the diagnosis. Clinicians should also take into account the patient's country of origin when assessing risks and interpreting results. It is important to identify underlying chronic liver disease and consider non-infectious causes of jaundice such as toxins. In recent years, there has been increasing recognition of hepatitis E as an important pathogen in travel-related (and locally acquired) hepatitis. Adventure tourism is gaining popularity and may put travellers at increased risk of leptospirosis. Health-related interventions undertaken abroad may increase the risk of hepatitis C acquisition. Liver abscesses may be amoebic or pyogenic and differentiation from cystic hydatid disease determines optimal management. Prognosis for infectious causes of liver disease is generally very good.