At conference we discussed a case of previously healthy patient presenting with fever, myalgias and RUQ tenderness after trip to Vietnam. They subsequently also had high degree AV block concerning for cardiac involvement. They were treated empirically with Doxycycline and improved, ultimately diagnosed with Leptospirosis which was acquired by exposure of non intact skin after a fall to contaminated water.
Learning points from today:
When caring for returning travelers, use the CDC website as a resource
History and physical examination are essential in the diagnosis of febrile illnesses in a returning traveler
Recognize the pattern of leukopenia, thrombocytopenia and transaminitis as a clue to specific infectious etiologies
Recognize the key differences between some of the common etiologies of fever (Dengue, Chikungunya, Leptospirosis, Malaria) in returning traveler)
This article about approach to fever in returning traveler is highly recommended as subsequent reading fever in returning traveler. Slides are also attached leptospirosis 10.28