Fièvre au décours d'un voyage en zone tropicale

Fever is a frequent reason for consultation when returning from tropical areas. It often poses diagnostic problems for clinicians and non-specialist biologists because, in addition to cosmopolitan infectious diseases, it can open up unusual and potentially serious etiological fields. Three fields must be systematically explored : “tropical” febrile illnesses (some of which may be expressed months or even years after return), cosmopolitan febrile illnesses acquired during the tropical stay (urinary tract infections, pneumopathy, etc.) and febrile diseases acquired after the return that can only be a diagnosis of elimination. Interrogation is a key element of the etiological approach, the accompanying signs and the delays of occurrence providing decisive elements. Malaria, mainly after a stay in sub-Saharan Africa, remains a constant concern and requires systematically and urgently looking for the presence of haematozoa. Nonspecific biology, and firstly the hemogram, provides valuable guidance. In addition to classical biological techniques (direct examination, serology, etc.), molecular biology is starting to enter into routine diagnostic strategies. Good communication between biologists and clinicians is essential for the diagnostic synergy to work as quickly as possible. Many of these “return” fevers are preventable by vaccine, chemoprophylaxis, vector prevention, or the respect of daily hygiene and the precautions recommended during travel medicine consultations before departure.