36F w/ fever for 6 days after the day of returning from Manzini, Eswatini. Stayed there 15 days, visited rural fields. Also, weakness, myalgia, night sweats, sore throat
What is your approach?
Many approaches possible.
Check out this amazing tweetorial by @BoggildLab
https://twitter.com/BoggildLab/status/1226586319901659137?s=20
- Common things being common: In addition to RTI, gastroenteritis, SSTI, UTI/STI, DO NOT want to miss: MDRT (malaria, dengue, rickettsial infections, typhoid fever)

Or this great video tutorial by @EvelynSongMD and @CPSolvers
https://clinicalproblemsolving.com/%20dx-schema-fever-in-a-returning-traveler/
2. Beware of transmissible infections➡️infection prevention: Ebola, Marburg, Lassa, TB, MERS, SARS, Influenza
Here, we wanted to review “ABCDE” mnemonic by @WuidQ
- Adventure
- Body
- Chronology
- Defend
- Exposure
#Adventure
Where did the patient travel?
https://wwwnc.cdc.gov/travel/destinations/list
- Central America
- Caribbean
- South America
- Subsaharan Africa
- Southeast Asia
- South Central Asia
Great approach by regions here:
https://www.nejm.org/doi/full/10.1056/NEJMoa051331

#Body for syndrome
1. Undifferentiated fever illness
2. Respiratory
3. Gastrointestinal: Diarrheal vs. Non-diarrheal.
4. Skin
5. Genitourinary
6. Other
https://www.nejm.org/doi/full/10.1056/NEJMoa051331
#Chronology
Time between travel/exposures to onset of symptoms (Period of incubation)
What do you think of this table? Any feedback?

#Defense
What vaccination/prophylaxis/medications did the patient receive?
Important information when thinking on preventable infections and resistant organisms.

#Exposure history.
Good mnemonic “I MD SOAPS” by @WuidQ
Special emphasis on:
Animals exposures/bites, vector bites
Food/water consumption
Water exposure
Activities (e.g. safari, caving, swimming, etc.)
In summary,
- Common things being common: Think MDRT: Malaria, Dengue, Rickettsial infections, Typhoid fever
- Beware of transmissible infections -> Infection Prevention
- #ABCDE approach
#ABCDE mnemonic summarized in this infographic

Originally tweeted by Infectious Diseases Fellows Network (@ID_fellows) on 11 August, 2020.