Diagnosis and Management of International Travel-Related Illnesses in Urgent Care Patients (Infectious Disease CME and Pharmacology CME)

Publication Date: October 2025 (Volume 4, Number 10)

CME Credits: 4 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 10/01/2028.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease credits and 2 Pharmacology CME credits, subject to your state and institutional approval.

Author

Mark K. Huntington, MD, PhD, FAAFP

Professor, University of South Dakota Sanford School of Medicine; Core Faculty, Sioux Falls and Pierre Rural Family Medicine Residency Programs, Center for Family Medicine, Sioux Falls, SD

Peer Reviewers

Hector M. Cabrera, MD, MPH

Medical Director, LCMC Urgent Care, New Orleans, LA

Jacqueline M. Vierheilig, MD

Infectious Disease Specialist, Certificate of Knowledge in Travel Medicine, Midland Park, NJ

Abstract

A significant number of people who travel internationally each year will develop a travel-related illness while traveling or shortly after returning. Many illnesses acquired abroad can be identified and treatment initiated in the urgent care setting. This review provides evidence-based guidance for the diagnosis and treatment of the most common presenting symptoms in returning travelers, including fever, diarrhea, and rash. Geographic distributions, incubation periods of pathogens, and comparisons of the clinical and laboratory features of different etiologies are provided to aid in diagnosis, with an emphasis on critical diseases that must not be missed. Specific pharmacological interventions and other treatment strategies are also discussed.

Case Presentations

CASE 1

A 32-year-old man who recently returned from a 1-week trip to Thailand presents to urgent care with a fever of 104.5˚F…

He also reports headaches, malaise, and nausea for the past 2 days.
He does not appear toxic and there is no rash.
The purpose of his trip was primarily business, but he says that he did some “touristy things” while he was in Thailand.
You wonder if this is a viral syndrome that needs only supportive care. Could the travel to Thailand be significant?

CASE 2

A 60-year-old woman with well-controlled hypertension presents to urgent care with a fever of 104˚F…

She also reports arthralgias, myalgias, and a retrobulbar headache.
She returned from a Caribbean cruise 1 day ago, and notes that her symptoms began on the last day of the trip.
She says that she tried to be careful about what she ate and only drank bottled water. She enjoyed the outdoor cafes during port-of-calls, but notes that “the mosquitoes were horrible.”
You wonder what “souvenir” she may have picked up…

CASE 3

A 20-year-old man presents to urgent care with a diffuse, pruritic rash of 10 days’ duration…

He returned a week ago from a month-long trip to Indonesia.
The trip was very low-budget, and he stayed primarily in youth hostels or “rustic” local inns in rural areas.
He reports that he ate “whatever looked good at the time.“
You wonder what may be “eating“ him…

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.