Management of Travel-Related Infectious Diseases in the Emergency Department.

IF 1.4 Q3 EMERGENCY MEDICINE

Current Emergency and Hospital Medicine Reports Pub Date : 2020-01-01 Epub Date: 2020-05-06 DOI:10.1007/s40138-020-00213-6

Laura Throckmorton, Jonathan Hancher

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引用次数: 2

Abstract

Purpose of review: Emergency physicians generally have limited exposure to internationally acquired illnesses. However, travelers can present quite ill, and delays in recognition and treatment can lead to increased morbidity and mortality. This paper aims to summarize typical presentations of common international diseases and provide the emergency physician with a practical approach based on current guidelines.

Recent findings: In the treatment of traveler's diarrhea, azithromycin has become the treatment of choice due to the growing antibiotic resistance. Intravenous artesunate was approved in 2019 under investigational new drug protocol for the treatment of severe malaria, and artemisinin-based combination therapies (ACTs) have become the first-line treatment for most cases of uncomplicated malaria. Since the 2015 outbreak, Zika has become a concern to many travelers, but the current treatment is supportive.

Summary: Clinicians should be aware of a few noteworthy updates in the treatment of internationally acquired illnesses, but more importantly, they must recognize warning signs of severe illness and treat promptly. Future research on workup and disposition could help emergency physicians identify which patients need admission in well-appearing febrile travelers.

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急诊部旅行相关传染病的管理

综述目的:急诊医生通常对国际获得性疾病的接触有限。然而，旅行者可能病情严重，识别和治疗的延误可能导致发病率和死亡率增加。本文旨在总结国际常见疾病的典型表现，并根据现行指南为急诊医生提供实用的方法。最新发现:在旅行者腹泻的治疗中，由于抗生素耐药性的增加，阿奇霉素已成为治疗的首选。2019年，根据治疗严重疟疾的试验性新药方案，静脉注射青蒿琥酯获得批准，以青蒿素为基础的联合疗法(ACTs)已成为大多数无并发症疟疾病例的一线治疗方法。自2015年爆发以来，寨卡病毒已经成为许多旅行者的担忧，但目前的治疗是支持性的。总结:临床医生应了解国际获得性疾病治疗方面一些值得注意的最新进展，但更重要的是，他们必须认识到严重疾病的警告信号并及时治疗。未来对检查和处理的研究可以帮助急诊医生确定哪些病人需要入院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Emergency and Hospital Medicine Reports EMERGENCY MEDICINE-

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期刊介绍： This journal aims to offer expert review articles on the most significant recent developments in emergency and hospital medicine, with particular emphasis on the transition of patient care from the emergency department to the hospitalist service. By providing clear, insightful, balanced contributions, the journal intends to serve 1) those who provide immediate medical attention to patients with acute injuries or conditions in emergency departments and emergency medical service settings, and 2) hospitalists who deliver comprehensive medical care in collaboration with physicians and other health care personnel responsible for hospitalized patients. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include acute coronary syndrome; chronic obstructive pulmonary disease; community-acquired infections; diabetes and metabolic disease; heart failure; hospital-acquired infections; pharmacology of acute care; shared practice and economic issues; and thrombosis.