Signos de alarma al regresar de un viaje

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Puntos para una lectura rápida

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Las enfermedades importadas potencialmente de mayor gravedad son el paludismo, las arbovirosis hemorrágicas, la fiebre tifoidea y la amebosis.
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Sigue siendo útil considerar que toda fiebre importada de África subsahariana es paludismo hasta poder demostrar lo contrario.
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Aunque las causas más frecuentes de fiebre procedente de otros destinos son otras, la fiebre siempre obliga a descartar el paludismo.
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Un paciente febril que presenta sangrado espontáneo debe ser aislado y no realizar ninguna extracción o manipulación de fluidos hasta haber contactado con las autoridades epidemiológicas territoriales.
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Los pródromos clínicos suelen ser inespecíficos. No obstante, la identificación de factores de riesgo (viajes mochileros o inmigrantes en visita a familiares), sus circunstancias (pacientes que no han realizado quimioprofilaxis antipalúdica) y el periodo de aparición de la fiebre (en general menor de 2 semanas) deben alertar.
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En los pacientes graves no hay que demorar el inicio de un tratamiento empírico combinado antipalúdico-antibiótico a la espera de resultados microbiológicos.

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Most cited references 14

Record: found
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Fever in returned travelers: results from the GeoSentinel Surveillance Network.

, J S Keystone, L. Weld … (2007)

Fever is a marker of potentially serious illness in returned travelers. Information about causes of fever, organized by geographic area and traveler characteristics, can facilitate timely, appropriate treatment and preventive measures. Using a large, multicenter database, we assessed how frequently fever is cited as a chief reason for seeking medical care among ill returned travelers. We defined the causes of fever by place of exposure and traveler characteristics. Of 24,920 returned travelers seen at a GeoSentinel clinic from March 1997 through March 2006, 6957 (28%) cited fever as a chief reason for seeking care. Of patients with fever, 26% were hospitalized (compared with 3% who did not have fever); 35% had a febrile systemic illness, 15% had a febrile diarrheal disease, and 14% had fever and a respiratory illness. Malaria was the most common specific etiologic diagnosis, found in 21% of ill returned travelers with fever. Causes of fever varied by region visited and by time of presentation after travel. Ill travelers who returned from sub-Saharan Africa, south-central Asia, and Latin America whose reason for travel was visiting friends and relatives were more likely to experience fever than any other group. More than 17% of travelers with fever had a vaccine-preventable infection or falciparum malaria, which is preventable with chemoprophylaxis. Malaria accounted for 33% of the 12 deaths among febrile travelers. Fever is common in ill returned travelers and often results in hospitalization. The time of presentation after travel provides important clues toward establishing a diagnosis. Preventing and promptly treating malaria, providing appropriate vaccines, and identifying ways to reach travelers whose purpose for travel is visiting friends and relatives in advance of travel can reduce the burden of travel-related illness.

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Record: found
Abstract: found
Article: not found

Autochthonous Crimean-Congo Hemorrhagic Fever in Spain.

Anabel Negredo, Fernando de la Calle-Prieto, Eduardo Palencia-Herrejón … (2017)

Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).

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Invasive amebiasis: an update on diagnosis and management.

Mônica R. O. G. C. M. Silva, Maria Salles, Mauro J C Salles … (2007)

In its invasive form, the trophozoite is responsible for clinical syndromes, ranging from classical dysentery to extraintestinal disease with emphasis on hepatic amebiasis. Abdominal pain, tenderness and diarrhea of watery stool, sometimes with blood, are the predominant symptoms of amebic colitis. Besides the microscopic identification of Entamoeba histolytica, diagnosis should be based on the detection of specific antigens in the stool or PCR associated with the occult blood in the stool. Amebic dysentery is treated with metronidazole, followed by a luminal amebicide. The trophozoite reaches the liver causing hepatic amebiasis. Right upper quadrant pain, fever and hepatomegaly are the predominant symptoms. The diagnosis is made by the finding of E. histolytica in the hepatic fluid, or in the necrotic material at the edge of the lesion in a minority of patients, and by detection of antigens or DNA. Ultrasonography is the initial imaging procedure indicated. The local perforation of hepatic lesion leads to important and serious complications.

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Author and article information

Contributors

Lluís Valerio

Journal

Journal ID (nlm-ta): FMC

Journal ID (iso-abbrev): FMC

Title: Fmc

Publisher: Elsevier Espana S.L

ISSN (Print): 1134-2072

ISSN (Electronic): 1134-2072

Publication date PMC-release: 8 January 2020

Publication date (Print): January 2020

Publication date (Electronic): 8 January 2020

Volume: 27

Issue: 1

Pages: 28-33

Affiliations

[0005]Programa de Salud Internacional Metropolitana norte, Institut Català de la Salut, Barcelona, España

Author notes

[* ]Autor para correspondencia. lvalerio.bnm.ics@ 123456gencat.cat

Article

Publisher ID: S1134-2072(19)30220-8

DOI: 10.1016/j.fmc.2019.07.004

PMC ID: 7144512

SO-VID: c18f2422-6e6d-491d-9d92-538198bb7687

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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Signos de alarma al regresar de un viaje

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Puntos para una lectura rápida

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Most cited references 14

Fever in returned travelers: results from the GeoSentinel Surveillance Network.

Autochthonous Crimean-Congo Hemorrhagic Fever in Spain.

Invasive amebiasis: an update on diagnosis and management.

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