Fever in the returning child traveller: approach to diagnosis and management

Halbert, J; Shingadia, Delane; Zuckerman, Jane N.

doi:10.1136/archdischild-2012-303196

Cited by 21 publications

(38 citation statements)

References 25 publications

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“…Its incidence in endemic countries can be as high as 540 cases per 100,000 population, making it a public health challenge [1]. In an Australian setting, it particularly affects returned travelers from the Asian subcontinent [2]. …”

Section: Discussionmentioning

confidence: 99%

Severe thrombocytopenia in a child with typhoid fever: a case report

2016

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BackgroundAlthough thrombocytopenia is common in typhoid fever, its course, response to treatment, and need for specific therapies such as platelet transfusion are not well characterized.Case presentationWe report a case of typhoid fever in a 4-year-old Asian male returned traveler, admitted with prolonged fever and found to have severe thrombocytopenia (platelets 16 × 109/L). Despite appropriate antibiotic therapy, his platelet recovery was slow, but did not lead to complications and he did not require platelet transfusion.ConclusionsThere is no consensus in the medical literature guiding the optimal management of severe thrombocytopenia in typhoid fever, but it may improve with conservative management, as in our case. The epidemiology and management of this condition merits further research to guide clinical practice.

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Section: Discussionmentioning

confidence: 99%

Severe thrombocytopenia in a child with typhoid fever: a case report

2016

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“…Ils sont nécessaires et peuvent se limiter initialement à ceux dont les indices de performance diagnostique ont été validés [4,5] : hémocultures, frottis avec goutte épaisse et test de diagnostic rapide (TDR) (si exposition possible au paludisme dans les 2 années précédentes, en dépit de la bonne observance prétendue de la prophylaxie, qui n'est pas efficace à 100 % ; délai du résultat 2 heures, à répéter dans les 12 h si négatif), numération formule sanguine (NFS), transaminases, protéine C réactive (CRP), bandelette urinaire [3]. Ces examens de première ligne sont à peu près consensuels en Europe [10]. Les résultats des premières investigations peuvent donner des arguments en faveur d'une infection (Tableau 3).…”

Section: Examens Complémentairesunclassified

Fièvre au retour de voyage chez l’enfant

Sorge

Velayudhan-Deschamps

Faye

et al. 2016

Archives de Pédiatrie

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Child travelers are numerous, exposed to the risk of diseases, both infectious and noninfectious, for which practitioners often lack experience. The assessment of febrile returning child travelers is becoming more frequent and challenging. The question of previous travel should be foremost in the checklist of the interview of any febrile child traveler, because this implies a possible tropical disease such as malaria that may be life-threatening. These need to be investigated and treated effectively and rapidly. There are highly contagious infections that could pose public health risks requiring implementation of hygienic and public health measures. A detailed immunization, medical, and travel history for exposure to infectious risks using geographic, seasonal, environmental, sociocultural, and epidemiological data are needed. Along with clinical examination and elementary first-line investigations, the history should guide second-line exams, which will provide the etiology and optimal treatment in approximately 75 % of cases. The majority of children will have a cosmopolitan infection that resolves spontaneously or is simple to treat. Malaria will need urgent and specific treatment. This article describes guidance on first-line evaluation and management of febrile child travelers as recommended in France.

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“…Depending on identification of specific and risk factors, one must consider more unique etiologies such as histoplasmosis, Legionella pneumophila, melioidiosis, and Q fever, as well as emerging viruses such as SARS coronavirus and MERS-CoV. 7,9,[60][61][62] These novel organisms highlight that nothing should be "taken for granted," and clinicians should be quick to consult with the continuously updated on-line resources regarding outbreaks and emerging infections discussed elsewhere in this supplement when evaluating unexplained serious respiratory disease in a recent traveler. For pediatric travelers, the use of a rapid diagnostic test for influenza and RSV are beneficial in the initial evaluation and should be performed on febrile children returning with respiratory complaints.…”

Section: Fever With Respiratory Symptomsmentioning

confidence: 99%