Return to Diagnosis ListShow Learning Points most relevant to Phase 1:

Febrile returning traveller

Clinical Discipline(s)/Organ System(s)
Infectious Diseases, Microbiology, Ethics, Haematology
Progress Test Topic(s)
Infectious disease
A 28 year old Canadian man has recently arrived in Auckland from a 2 month holiday in Laos. Whilst in Laos he visited jungle and rural areas, swam in rivers and had a sexual liaison with a German backpacker. He visits his GP with intermittent fever, sweats, lethargy and loose bowel motions. His symptoms have been present for 5 days.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Physiology of fever
   - Pathogenesis of malaria and other arthropod borne infections including Dengue fever, sexually transmitted infections (STIs) and food and water borne infections such as hepatitis A and typhoid fever
   - Pharmacology of anti-malarial drugs
Clinical and Communication Skills 
   - History from a febrile patient
   - Travel and exposure history
   - Elicit sensitive information, particularly of
sexual activity and injecting drug use
   - Perform an examination of a patient with fever
   - Differential diagnosis of the febrile returning traveller
   - Select and interpret tests used to diagnose malaria (thin and thick blood films, malaria antigen tests); STIs (urethral and pharyngeal swabs and self-collected urine sample tested for gonorrhoea and chlamydia); blood cultures and faeces to culture Salmonella typhi, Campylobacter jejuni
   - Management of malaria and other infections commonly encountered by travellers
   - Complications of malaria, typhoid fever, viral hepatitis and tuberculosis
   - Management of needlestick injury
Personal and Professional Skills 
   - Identifying reputable sources of information
   - Intimate discussions
   - Confidentiality
Hauora Māori 
   - Awareness of stereotypes and bias
Population Health 
   - Public health controls of STIs, safe sex and contact tracing
   - Notifiable infectious diseases: process, contact tracing, treatment and prophylaxis
   - Global burden of infectious disease (including malaria)
   - Ethics and economics of treatment of infectious diseases in developing countries
   - Worldwide prevalence of malaria according to region and recommendations for prophylaxis for travellers
Conditions to be considered relating to this scenario
malaria, hepatitis A, hepatitis B, hepatitis C, typhoid fever, sexually transmitted infections, intestinal pathogens
Less common but 'important not to miss'
occult bacterial infection, amoebic colitis or liver abscess, cytomegalovirus (CMV), Epstein-Barr virus (EBV), other causes of fever including malignancy and connective tissue disease
leptospirosis, tuberculosis