Imported diseases in the emergency room

Introduction: the increase in migratory movements and travel to low-resource countries in recent years has led to an increase in the incidence of infectious diseases that are uncommon in Spain. The objective of the study was to describe the characteristics of patients with imported disease in the emergency room.

Methods: a retrospective study was conducted between 2012-2019. The study included children under 16 years of age with a history of international travel in the past 3 months managed in the emergency department of the Hospital de Torrejón. We collected demographic and clinical data. Diagnoses were grouped into three categories: tropical infection (typically imported from tropical areas), communicable infections (including infections with global distribution and a greater prevalence in tropical areas, such as tuberculosis) and common infections.

Results: the sample included 100 children were included. The median age was 3 years, and 53% were female. Eighty-seven percent had visited sub-Saharan Africa. The reason for the trip was to visit friends and relatives in 43% of cases, immigration in 45% and tourism in 9%. Four percent received prophylaxis against malaria. Twenty-four received a diagnosis of malaria, without a history of fever in 6. Other tropical infections included dengue, chikungunya and liver abscess. Five children received diagnoses of communicable infections (HIV, tuberculosis, meningitis, hepatitis A, giardiasis), and 67 children of common infections.

Conclusions: malaria was the second most frequent diagnosis in children with fever following travel to an endemic area, after common infections. In our study, the initial presentation of life-threatening imported diseases were indistinguishable from those banal infections.