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Further investigations should follow once a diagnosis is suspected. While some of these tests are diagnostic, the results of others should be interpreted in combination with clinical features, which would help in making a definitive diagnosis. #Undifferentiated_Fever_Screening
In cases of leptospirosis, conjunctival hyperaemia (‘suffusion’), pharyngitis, calf and muscle tenderness, splenomegaly, lymphadenopathy and hepatomegaly are seen. Skin rash typically lasts for 1–2 days and may be maculopapular or petechial in nature. ‘Weil’s disease’ is a severe form of leptospirosis, and is described as a classic triad of fever, jaundice and renal failure.Neurological complications, meningitis, encephalitis, convulsions, Guillain–Barré syndrome, transverse myelitis and ocular complications, such as subconjunctival and retinal haemorrhages, optic neuritis and chronic uveitis, might be involved. #Leptospirosis_Exam
#Traveller_Fever_Examination Urine should be examined by dipstick initially for blood and glucose.
Rickettsial diseases are the most common tick-borne infection transmitted through bites or contact with ticks, lice or fleas or infected saliva of biting vectors, such as rats. Rickettsiae are intracellular Gram-negative organisms. The two main groups of rickettsial diseases are spotted fever group and typhus group. Patients present acutely with a headache, which is often retro-orbital in nature, fever, rash and, sometimes, neurological symptoms. Infections are commonly seen in travellers on safari or trekking, or those who have visited rural areas. #Rickettsial_Infection
Malaria is caused by Plasmodium falciparum, P. vivax, P. ovale and P. malariae. It is transmitted by Anopheles mosquitoes and occurs throughout the tropics and subtropics. Malaria should be suspected in any febrile individual with unexplained fever, a history of recent travel (within one year) to a malaria-endemic country (especially India, Pakistan, Haiti
and African countries) and belonging to high-risk groups
(eg businessmen, overseas workers, migrants, refugees, asylum seekers and security forces returning from peace- keeping missions). Immigrants returning to their country of origin after a long residence in Australia are also at high risk, as they have lost their partial immunity and do not realise that they should be taking malaria prophylaxis. #Malaria
The dengue flavivirus is transmitted through two vectors, the Aedes aegypti and Aedes albopictus mosquitoes (known as dengue mosquito in Queensland), and is a common cause of fever in the tropics in large cities. There are four serotypes of dengue virus, all producing a similar clinical syndrome. Asymptomatic infections are common. Prodromal illness of two days with malaise and headache is followed by fever (lasting 2–7 days), backache, arthralgias, incapacitating body aches and pains (breakbone fever), pain on eye movement, nausea, vomiting, anorexia etc. #Dengue_Fever
