[Tick-borne relapsing fever : An unrecognized cause of fever in travellers]. / La fièvre récurrente à tiques : une cause méconnue de fièvre du voyageur.

INTRODUCTION: Tick-borne relapsing fever is a usual cause of fever in West Africa. Except relapsing febrile episodes, there are no pathognomonic signs and diagnosis is difficult because Borrelia density in patient's blood is low. CASE REPORTS: Tick-borne relapsing fever was revealed by the presence of spirochetes in a blood sample to search malaria in two men, 24 and 31 year-old, returned from Mali. CONCLUSION: This diagnosis should be evocated in patients having fever after a trip in infested area, as malaria, both infections can be associated.

Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection.

Reported cases of dengue are rising in South Australia (SA) in travellers returning from dengue-endemic regions. We have undertaken a retrospective analysis to identify the clinical and laboratory characteristics of patients returning to SA with suspected dengue virus (DENV) infection. From 488 requests, 49 (10%) were defined by serology as acute dengue, with the majority of patients (75%) testing as non-structural protein 1 (NS1) and/or IgM positive. Dengue was most commonly acquired in Indonesia (42.9%) with clinical features of fever (95%), headache (41%) and myalgia/arthralgia (56%). The presence of rash (36%) and laboratory findings of neutropenia, leukopenia, thrombocytopenia, but not elevated C-reactive protein, were distinct from findings in DENV-seronegative patients. Available dengue seropositive samples were analysed by RT-PCR, with 14/32 (43.8%) positive by a serotype non-specific DENV assay, but 28/32 positive (87.5%) when also assessed by serotype-specific RT-PCR. Serotype analysis revealed the predominance of DENV-1 and DENV-2 and the presence of DENV-3, but not DENV-4 or Zika virus (ZIKV). Thus, dengue in returned travellers in SA presents in a manner consistent with World Health Organization (WHO) definitions, with symptoms, travel history and laboratory results useful in prioritising the likelihood of dengue. This definition will assist the future management in DENV-non-endemic regions, such as SA.

Infectious disease following travel to developed regions: a snapshot of presentations to an Australian travel medicine clinic.

Much of the travel medicine literature focuses on travel to 'developing' regions by travellers from 'developed' regions; however literature about travel to developed regions is scarce. This article examines presentations to a travel medicine clinic over a 17-year period with illnesses resulting from travel to developed regions. From a cohort of general presentations to the clinic of 1077 patients, 85 patients acquired infections due to travel to developed regions, with a total of 99 infectious diagnoses made. This serves to highlight the risk of infectious disease even among travel to only developed regions, and the importance of travel advice in these situations.

Burkholderia pseudomallei osteomyelitis: An unusual cause of fever in a returned traveller.

A 52-year-old diabetic man presented to the Emergency Department with a history of fevers and pain in his right thigh. He had recently returned from a 10-month trip to Vietnam. A suspected bacterial abscess in the right thigh did not respond to empirical antibiotics. Subsequent investigations revealed melioidotic osteomyelitis of the femur. This case emphasises the need to consider the diagnosis of melioidosis in patients presenting with fever following travel in endemic areas.