Emergency Department Clinical Pathway for
Fever in the Returned Traveler

Sepsis Screen Positive
  • Sepsis Huddle as clinically indicated
  • ED Sepsis Pathway
  • Consider
    • Severe Malaria
    • Typhoid
    • Dengue
  • Triage
  • Complete:
RDT Not Applicable
Negative RDT
Positive RDT
  • Reassuring VS and PE
  • No significant anemia/hemolysis
  • Ability for PCP f/u within 24 hrs
  • Patient ill appearing or
  • Neurologic signs/symptoms or
  • Significant anemia (Hgb< 7, evidence of hemolysis)

Re-Consider General Fever Pathway and other infectious pathways for focal infections.

  • Review Criteria for Severe Malaria
  • Treat w/ antimalarials
  • Consider co-infection
  • Consider Empiric treatment w/ broad spectrum
    • antibiotics for ill appearing patients
Discharge
Admission
  • Ensure adequate hydration
  • Reassuring VS, PE
  • Fever care, specific discharge instructions
  • Follow-up recommendations
Posted: November 2021
Authors: K. Cohn, MD, MPH; A. Vinograd, MD, MSHP; E. Sanseau, MD, MS; K. Laycock, MD; A. Steenhoff, MBBCh, DCH; E. Kitt, MBBCh BAO.