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前往热带地区旅行后发热患者的实用处理方法。

Practical approach to a patient with fever who travelled to the tropics.

机构信息

Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland.

Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland

出版信息

Pol Arch Intern Med. 2024 Mar 27;134(3). doi: 10.20452/pamw.16660. Epub 2024 Jan 11.

Abstract

By 2030, an estimated 2 billion international tourist trips are expected annually worldwide, with citizens of Poland as important contributors. Illness rates among returnees from developing regions range between 43% and 79%. Properly diagnosing fever in these travelers is vital due to potentially serious implications. After visiting tropical and subtropical zones, the main health complaints are diarrhea, fever, and skin lesions. A reliable diagnosis begins with taking a comprehensive travel history and identifying potential risks. In travelers returning from sub‑Saharan Africa, malaria caused by Plasmodium falciparum is the main cause of fever, affecting 50 in every 1000 cases. Among returnees from Southeast Asia, dengue is dominant, occurring in 50-60 per 1000 cases, and its prevalence rises significantly nowadays. Other significant diseases include chikungunya, Zika, typhoid fever, amebic liver abscess, and occasionally viral hemorrhagic fevers. SARS‑CoV‑2 and influenza viruses are crucial pathogens as well. An in‑depth assessment of the travel history, combined with knowledge on tropical diseases, are key to the diagnostic process, and algorithms may be helpful in selecting appropriate tests and treatment methods.

摘要

到 2030 年,预计全球每年将有 20 亿人次的国际旅游,波兰公民将是重要的贡献者。来自发展中地区的归国人员的发病率在 43%至 79%之间。由于潜在的严重影响,正确诊断这些旅行者的发热至关重要。在前往热带和亚热带地区后,主要的健康问题是腹泻、发热和皮肤损伤。可靠的诊断始于全面的旅行史和识别潜在风险。在从撒哈拉以南非洲返回的旅行者中,由恶性疟原虫引起的疟疾是发热的主要原因,每 1000 例中有 50 例受到影响。在从东南亚返回的旅行者中,登革热占主导地位,每 1000 例中有 50-60 例,如今其发病率显著上升。其他重要疾病包括基孔肯雅热、寨卡病毒、伤寒、阿米巴肝脓肿,偶尔还有病毒性出血热。SARS-CoV-2 和流感病毒也是重要的病原体。深入评估旅行史,并结合对热带疾病的了解,是诊断过程的关键,算法可能有助于选择适当的检测和治疗方法。

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