PT  - JOURNAL ARTICLE
AU  - Tolle, Michael A.
TI  - Evaluating a Sick Child after Travel to Developing Countries
AID  - 10.3122/jabfm.2010.06.090271
DP  - 2010 Nov 01
TA  - The Journal of the American Board of Family Medicine
PG  - 704--713
VI  - 23
IP  - 6
4099  - http://www.jabfm.org/content/23/6/704.short
4100  - http://www.jabfm.org/content/23/6/704.full
SO  - J Am Board Fam Med2010 Nov 01; 23
AB  - Every year, millions of children travel internationally with their families, many to developing countries. Although the vast majority experience uneventful travel and return home well, it is not uncommon for children to present as ill during or after travel. Although the majority of travel-associated illness is mild and self-limited, serious conditions regularly occur. Almost all life-threatening conditions after travel present with fever, and malaria is the most important of these to rapidly exclude. Gastrointestinal symptoms are common after travel in the developing world, and most diarrhea in child travelers has a bacterial source. Children who have a rash in association with fever or who appear ill should receive a priority work-up focused on ruling out serious conditions. Many children traveling internationally experience respiratory illness during or shortly after travel, mainly common upper respiratory infections, yet serious conditions, such as tuberculosis, may occur. Eosinophilia is common in the returned pediatric traveler, particularly those with prolonged stays in the tropics. Not all eosinophilia is caused by parasitic infection; drug reactions, asthma, and other allergic conditions are also common causes. With a focus first on ruling out life-threatening disease and subsequently on an informed and efficient path to diagnosis and treatment, clinicians may confidently provide care for this challenging group of patients.