Travel related and tropical infections
Red flags
Consider urgent referral for patients with the following:
- Altered conscious level
- Breathing difficulty
- Abnormal bruising or bleeding
- Petechial rash
- Persistent vomiting
- Dehydration
- Paralysis
- Jaundice
Travel related and tropical infections include:
- Malaria
- Dengue fever
- Chickungunya
- Typhoid
- Cholera
- Schistosomiasis/bilharzia
- Ebola (very rare)
- Lyme disease
Most tropical diseases will present with an acute illness and may require urgent transfer through Emergency. However, others present with early, low grade symptoms that may provide an opportunity to investigate and initially manage within a primary care setting.
Other important information for referring practitioners
Medical management
An extensive review of tropical disease is outside the scope of these ID guidelines but the following may help in logical diagnosis and management based on main symptoms.
Diarrhoea
- Most commonly caused by E.coli as traveller’s diarrhoea. Most cases resolve spontaneously. However, if:
- Frequent bowel action, vomiting, fever or blood in stool, may benefit from antibiotic treatment
- Use ciprofloxacin 500mg bd or norfloxacin 400mg bd for 3-5 days
- Frequent bowel action, vomiting, fever or blood in stool, may benefit from antibiotic treatment
- If persistent investigate with:
- Stool microscopy and culture and PCR
- If diarrhoea is chronic, consider stool for lactose intolerance testing
- Consider abdomen U/S and or endoscopy (upper and/or lower)
Respiratory disease
Commonly caused by:
- Influenza
- Bacterial pneumonia
- Rarely TB, Pandemic respiratory illness
- Investigate with:
- Sputum Micro C&S
- CXR
Lymphadenopathy
- Consider Dengue, rickettsial infection, HIV, brucellosis, leishmaniasis, lymphogranuloma venereum, plague
Skin rash
- Can be non-specific or heat related
- If petechial consider meningococcal disease, yellow fever, rickettsial infection of viral haemorrhagic fevers
- Generalised rash can be seen in dengue fever, measles, rubella
Jaundice
- Consider viral hepatitis, cholangitis, liver abscess, typhoid fever, leptospirosis, yellow fever, dengue fever and haemoglobinopathies. Rarely malaria.
Hepatosplenomegaly
- Consider viral hepatitis, malaria, brucellosis, typhoid fever, leishmaniasis, schistosomiasis and toxoplasmosis
Gross Splenomegly
- Consider malaria, visceral leishmaniasis, trypanosomiasis, typhoid, brucellosis, typhus and dengue fever
Anaemia
- Consider hookworm, malaria and visceral leishmanisis
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
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