ID seminar - Fever in returning traveller

Fever in the returning traveller

- worksheet
Learning Objectives
In conjunction with the information on the VLE to understand the basic principles of
managing a febrile returning traveller by discussion of 2 cases.

For the discussion to be successful the student should read through the
VLE notes on this topic before the seminar
Case 1 - You are an FY1 in MAU

A 19 year old male returned 3 days ago from a 10 month trip around Sub-Saharan
Africa. He had 2 episodes of watery diarrhoea while there lasting 2-3 days but
otherwise had been well. Previously fit and well. Student born in Leeds on gap
year.
Now complains of increasing sweats, rigors, headache and watery diarrhoea over
the last 5 days.
Examination
o Temp 39, BP 80/50, Pulse 120 regular, Resps 25, O2 Sats 99% on 40%
oxygen. He looks unwell but cardiovascular, respiratory, abdominal and
neuro exam normal apart from the observations above

Questions to be discussed in the seminar:

What further history would you like?
(You will be provided with some additional history in the tutorial)

What is your differential diagnosis?

What initial investigations do you want?

(you will be provided with results of initial tests)

What is your differential diagnosis now?

(based on the test results)

What treatment and further management will you do now?

ID seminar - Fever in returning traveller

Case 2 - you are still an FY1 in MAU

40 year old British Asian male has returned from visiting his family in
Pakistan

Previously well, taxi driver

Complains of 7 day history of headache, fevers, shivers and dry cough.

Examination
o Temp 38, Pulse 80, BP 90/60, Resps 18, Sats 98% on air. HS
normal, Chest few crackles left base, Abdo slightly distended,
non tender.
Questions to be discussed in the seminar:
What further history would you like?
(You will be provided with some additional history in the tutorial)

What is your differential diagnosis?

What initial investigations do you want?

(you will be provided with results of initial tests)

What is your differential diagnosis now?

(based on the test results)

What treatment and further management will you do now?