QuestionSBA
QuestionChoice
There are no respiratory infective symptoms, such as cough or shortness of breath, to suggest chest infections. This may be a part of the initial investigations to identify signs of any lung pathologies like Tuberculosis (fever in returning travellers) or malignancies like lymphoma (fever). However, the investigation is not diagnostic and the cyclical fever pattern is more indicative of malaria than a respiratory cause.
10002993
c
Chest X-Ray
QuestionChoice
This is generally a part of the initial investigations for fever in a returning traveller. Raised CRP is a sign of inflammation and elevated white cells may be seen in other causes of fever like neutrophils in TB etc. However, this is not diagnostic of any condition and just indicates the presence of an infection. In malaria, neutrophils may be elevated and lymphocytes may be reduced.
10002992
b
CRP and WCC
QuestionChoice
This can be conducted to identify any viral causes of fever in returning travellers like dengue. However, the presentation of dengue fever would not be cyclical, so this investigation is less likely to be diagnosing the cause of the fever.
10002995
e
Serology and viral PCR
QuestionChoice
For fever in a returning traveller from the tropics, Malaria is an important diagnosis to rule out. A pattern of cyclical fever over 24-48 hours, chills, night sweats and muscle aches is characteristic of Malaria, with an incubation period <7 days typical for *Plasmodium falciparum*. The diagnosis is made by analysing thick film for the presence of parasites, and thin film to identify the species causing the infection.
10002991
a
Thick and thin blood films
QuestionChoice
This may be a probable investigation to rule out fatal causes of fever in returning travellers like Japanese encephalitis (JE). However, the patient does not present with any symptoms like headache, neck stiffness or seizures. Also, the risk of contracting JE is very low, so it is less likely to be the cause of the fever.
10002994
d
Lumbar Puncture
Concept
Chapter
2693
4100
Fever in the returning traveller
Topic
194
Infectious Diseases
13145
A 21-year-old male presents to A&E with on-and-off fevers and chills for the past 36 hours. He complains of muscle aches and waking up in a pool of sweat last night.

He just returned from Malaysia a week ago from a business trip. He did not take any vaccinations before travelling. What is the best investigation to diagnose the ongoing condition?
a