Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 22-2003. A 22-year-old man with chills and fever after a stay in South America

Malaria Primer for Clinicians in the United States

Though low, the incidence of malaria in the United States is not insignificant and can be the source of infection in febrile travelers returning from endemic areas. Clinicians practicing in the United States must have a basic understanding of the malaria life cycle and its treatments to properly diagnose and treat this potentially fatal disease. Malaria chemotherapy can be broken into clinical classes for easier understanding, and any traveler to a malaria-endemic region should be placed on prophylactic medications. Mosquito bite prevention should be undertaken by all travelers, and methods of deterring mosquito bites should be understood.

Life-threatening dermatoses in travelers

Life-threatening dermatoses in travelers relates to infections, or allergic or drug reactions. Of the infectious dermatoses, most are parasitic or viral- because of the short time frame. Bacterial infections usually have a longer incubation. More significant are allergic reactions from environmental or dietary causes, and drug reactions, especially those drugs taken for prophylaxis from tropical diseases. All of these can be fulminant and therefore an awareness and early therapeutic intervention is mandatory.