Applied Evidence
Another risk to US travelers—malaria
To individualize preventive measures, rely on reported risk data for specific destinations, planned activities, and patient comorbidities.
Finally, instruct travelers to perform daily tick inspections and shower or bathe as soon as possible after returning from the outdoors.9 Educate patients on the proper technique for tick removal, which is described on the Centers for Disease Control and Prevention’s Web site at http://www.cdc.gov/ticks/removing_a_tick.html.
Our patient completed a 2-week course of doxycycline 100 mg bid. His symptoms and laboratory abnormalities completely resolved.
THE TAKEAWAY
ATBF is the most common rickettsiosis among patients returning from international travel. Because patients may present with several nonspecific symptoms, maintain a high index of suspicion for rickettsial infection among patients returning from sub-Saharan Africa or the West Indies. Though the disease usually can be successfully managed in the outpatient setting with doxycycline, elderly patients or those with comorbid conditions may require inpatient care. Educate patients who plan to travel to an endemic area about measures they can take to prevent exposure to ticks and subsequent infection.