O'Brien D, Tobin S, Brown G V, Torresi J
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Victoria, Australia.
Clin Infect Dis. 2001 Sep 1;33(5):603-9. doi: 10.1086/322602. Epub 2001 Aug 6.
We reviewed 232 consecutive patients admitted to a tertiary-care hospital under the care of an infectious diseases unit for management of febrile illness acquired overseas. A total of 53% presented to hospital within 1 week of return and 96% within 6 months. Malaria was the most common diagnosis (27% of patients), followed by respiratory tract infection (24%), gastroenteritis (14%), dengue fever (8%), and bacterial pneumonia (6%). Pretravel vaccination may have prevented a number of admissions, including influenza (n=11), typhoid fever (n=8) and hepatitis A (n=6). Compared to those who had not traveled to Africa, those who had were 6 times more likely to present with falciparum than nonfalciparum malaria. An itinerary that included Asia was associated with a 13-fold increased risk of dengue, but a lower risk of malaria. Palpable splenomegaly was associated with an 8-fold risk of malaria and hepatomegaly with a 4-fold risk of malaria. As a cause of fever, bacterial pneumonia was > or =5 times more likely in those who were aged >40 years.
我们回顾了在一家三级医疗医院传染病科接受治疗的232例连续患者，这些患者因在海外感染发热性疾病而入院。共有53%的患者在回国后1周内入院，96%在6个月内入院。疟疾是最常见的诊断（占患者的27%），其次是呼吸道感染（24%）、胃肠炎（14%）、登革热（8%）和细菌性肺炎（6%）。旅行前接种疫苗可能避免了一些入院情况，包括流感（n = 11）、伤寒热（n = 8）和甲型肝炎（n = 6）。与未前往非洲的人相比，前往非洲的人出现恶性疟原虫感染的可能性是非恶性疟原虫感染的6倍。包含亚洲的行程与登革热风险增加13倍相关，但疟疾风险较低。可触及的脾肿大与疟疾风险增加8倍相关，肝肿大与疟疾风险增加4倍相关。作为发热原因，40岁以上人群患细菌性肺炎的可能性是其他人群的5倍或更多。
