Infections In Returning Travelers

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Thank you all for the enthusiasm! #WeAreID #IDTwitter #IDfellows#IDTweetorial
36F w/ fever for 6 days after the day of returning from Manzini, Eswatini. Stayed there 15 days, visited rural fields. Also, weakness, myalgia, night sweats, sore throat

What is your approach?

— Infectious Disease Fellows Network (@ID_fellows) August 11, 2020

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Friday Fellow Conference!! @WendyStead5 reviews fever in the returning traveler!

What happens in the tropics doesn’t always stay in the tropics#IDTwitter #MedTwitter #IDMedEd

Let’s review some learning points!! pic.twitter.com/uvjswW4dlN

— BIDMC Infectious Diseases Fellowship (@BIDMC_IDFellows) June 19, 2020

What is the most likely pathogen?

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) September 19, 2019

Images of Infectious Diseases

22F
3 mo Ghana trip
CC fatigue, fever

PE: ill-looking, somnolent, jaundice, hepatosplenomegaly

Hgb 7.9 plt 8
LDH 1343; hapto <14
AST 124; bili 14
Cre 1.1; glu 60; bicarb 15

Smear (photo)
Identify the species / share a clinical pearl
(Poll Next) pic.twitter.com/0zDPS2370r

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) October 21, 2019

In the middle of MN winter,
35F DM went to Jamaica for 10d trip

1 day after return: flu-like illness, F/C, myalgia, retroorbital HA, transient rash

4d later:
WBC 3.8. ALC 0.84. Hct 0.48. Plt 106.
Cre/AST/Bili normal
Blood culture (-)

Which could have prevented this infection?

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) January 19, 2020

53M rash (photo) on ankle after Costa Rica trip. No systemic symptoms.

Exposure: whitewater rafting, swimming, local food trips, outdoor camping

Skin biopsy: dermal inflammation with parasitized histiocytes.

What activity most likely predisposed to this infection? (see poll) pic.twitter.com/iK8z9d2CWZ

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) August 6, 2019

#IDboardReview 60 M carpenter w/ non-healing painless leg ulcers x1mo, recent travel to Belize, no improvement w/doxy. Diagnosis? #medEd #IdmedEd #IDtwitter pic.twitter.com/IGqIsXGRhR

— Indiana University Infectious Diseases Fellowship (@IUIDfellowship) July 1, 2020

🌟24M w/ fever, n/v, abd pain, diarrhea, headache. Exam: 39.5 C, hepatomegaly. Labs: wbc 15 (20% eos, 50% L), Plt 160, Hgb 14, AST 80, ALT 40. CXR: nl. Was in rural Philippines 2 mos ago, +mosquito bites, +walked in rice paddy, +ate street food, +walked bare foot. Most likely dx?

— WuidQ: Washington University ID Questions (@WuidQ) July 30, 2018

35/M, returning from India 1 wk ago p/w fevers and chills .
Took Azithro x 1d , 7days ago suspecting travelers diarrhea.
No rash, cough, URI . Continues to be febrile.

Blood cx x 2 (-).Malaria smears (-) .

Test with highest sensitivity to dx typhoid fever in this scenario ?

— WuidQ: Washington University ID Questions (@WuidQ) December 6, 2019

(Part 1 of 2, MCQ in Part 2)

52/M, no PMH, recent immigrant from Taiwan, p/w 3 d fever, headache, N/V. WBC 28, Hgb 11, Plt 540. CSF: WBC 900 (87% N), glucose <20, TP 200. Brain MRI (-). CT +4×6 cm liver abscess. Now living in California. CSF Gram stain & culture shown below. pic.twitter.com/zIsdMIWvzL

— WuidQ: Washington University ID Questions (@WuidQ) August 13, 2019

Images of Infectious Diseases

62M. Kuwait. Now s/p liver transplant for NASH. H&E stain of explanted liver (photo)

What is the diagnosis and treatment recommendation? #MayoIDQ MCQ to follow… pic.twitter.com/YtxSU2IXD2

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) July 13, 2020

31M. No PMH. South African farmer.

2 days after arriving in MN: F/C, HA, body aches, myalgia

Exposure: cattle, sheep, ticks, mosquitoes

PE: no distress
Skin (photo) + faint rash in torso

HIV / Malaria (-)
CBC / BMP / CT head / LP normal

What is your DDx? #MayoIDQ (MCQ next) pic.twitter.com/VjXyCfXLN6

— Mayo Clinic Infectious Diseases (@MayoClinicINFD) November 27, 2019