Author/Editor     Logar, Mateja
Title     Sodobni pristop k bolniku po vrnitvi iz tropskih krajev
Translated title     New approaches to the patient after the return from tropical destinations
Type     članek
Source     In: Beović B, Strle F, Čižman M, editors. Okužbe pri transplatirancih. Novosti v infektologiji. Infektološki simpozij 2005; 2005 mar; Ljubljana. Ljubljana: Slovensko zdravniško društvo, Sekcija za kemoterapijo,
Publication year     2005
Volume     str. 47-63
Language     slo
Abstract     Despite the risk of emerging and re-emerging infectious diseases and the recent threat of terrorism, international tourist arrivals remain high, as does travel from industrialized to developing countries. Travel medicine is the discipline devoted to the maintenance of the health of international travelers through health promotion and disease prevention. Sometimes that is not enough and the travelers return sick from their travel. Asymptomatic short-term travelers rarely need a medical post travel examination. The long-term traveler needs a more thorough medical interview to asses potential exposer to a variety of infections. A total of 2 - 3% of return travelers present with fever. Many febrile infections are associated with focal signs and symptoms that can limit the differential diagnosis. Routine laboratory results may provide clues to the final diagnosis. Patients with any fever pattern should be considered to have malaria until proven otherwise when they have been to endemic areas. Immediate diagnosis and treatment are the key factors in reducing fatalities from malaria. Malaria treatment options are determined by the species involved, the severity of disease and the expected resistance pattern. Dermatoses occurring after return are usually of infectious origin, and about 50%, are tropical diseases. Although most cases of travelers' diarrhea are acute and self limited, it is important for physicians who treat returning travelers to be aware of a significant percentage of patients who develop persistent gastrointestinal symptoms. The pathogenesis generally falls into one of three broad categories: persistent infections, past infectious processes or chronic gastrointestinal illnesses unmarked by the infection. Eosinophilia occurs in up to 10% travelers. It may be caused by a variety of conditions. (Abstract truncated at 2000 characters)
Summary     Kljub globalnim grožnjam zaradi izbruha novih in ponovnega pojava starih infekcijskih bolezni ter novi zaskrbljenosti zaradi mednarodnega terorizma ostajajo mednarodni turistični prihodi številni kot tudi potovanje iz industrializiranih v manj razvite države. Potovalna medicina je panoga, usmerjena k vzdrževanju zdravja mednarodnih popotnikov s pomočjo svetovanja glede zdravega načina življenja in preventive bolezni. Vendar včasih to ni zadosti in se popotniki s potovanja vrnejo bolni. Brezsimptomi popotniki, ki so se vrnili s krajšega potovanja, večinoma ne potrebujejo pregleda pri zdravniku. Ljudje, ki so bili dalj časa na potovanju ali so v tropih delali, potrebujejo nekoliko natančnejši zdravstveni pogovor za oceno morebitnih tveganj za okužbe. Približno 2-3% popotnikov ima po vrnitvi s potovanja vročino. Številne okužbe, ki potekajo z vročino, imajo pridružene znake in simptome, ki zožijo diferencialno diagnostične možnosti. Temeljne laboratorijske preiskave nas lahko usmerijo h končni diagnozi. Pri vseh bolnikih s povišano temperaturo, ki so bili v malaričnem področju, moramo domnevati, da imajo malarijo, dokler ne dokažemo drugače. Takojšna diagnoza in zdravljenje sta pomembna za zmanjšanje umirljivosti zaradi malarije. Načini zdravljenja so odvisni od povzročitelja, stopnje bolezni in pričakovane odpornosti povzročiteljev na empirično predpisana zdravila. Kožne spremembe, ki se pojavijo po vrnitvi s potovanja, so večinoma posledica okužb in so kar v 50% odsev tropske bolezni. Čeprav je večina primerov driske na potovanju akutnih in minejo sami od sebe, se moramo zavedati, da se pri delu popotnikov pojavijo vztrajne težave s strani prebavil. (Izvleček skrajšan na 2000 znakov)
Descriptors     TRAVEL
TROPICAL CLIMATE
COMMUNICABLE DISEASES
FEVER
DIARRHEA
SKIN DISEASES
EOSINOPHILIA