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The returning traveler

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Mohamed Ridha

on 7 December 2017

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Transcript of The returning traveler

The returning traveler
Brief introduction to tropical diseases
10 cases
One rule for every single individual who comes back from a recent travel...
By the end, no one will get a tropical AMK question wrong if they follow this rule.
25 year old man has recently returned from Hajj. He was born in Iran and migrated to the UK when he was 7. He came in with a sore throat. He was advised to take some rest. 3 days later, he came to the ED with thick bulky lympadenopathy, dysphagia and serosanguinous purulent discharge. There was a grey membrane visible in his pharynx.
19 year old female returns from Ghana. She presents with pyrexia (40°C). She complains of bloody stools preceding this. O/e she has abdominal distension, hepatosplenomegaly and a strange rash on her torso. Blood cultures come back negative and she passes away due to bowel perforation, resulting in overwhelming sepsis.

Poor sanitation
A 19 year old student returns from a trip in Costa Rica. He has a fever of (39°C). His BP is 85/40. He complains of a retrorbital headache and appears delirious. O/E he has multiple mosquito bites and he appears pale. His bloods are significant for leucopenia and thrombocytopenia.
Gap year
A 10 year old child went swimming in Lake Victoria. 3 weeks later, he develops a large spiking fever, malaise, headache, frank haematuria and anemia. His blood tests show the following.
Hb 12.5 g/dl (13.5-18)
WCC 12.1 x10*9 (4-11)
Neut 7 x10*9 (2-7)
Lymph 2 x10*9 (1-4)
Full transcript