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
All Infants/Children Unvaccinated for Measles
  • Mask immediately
  • Expedite to AIIR
  • Door remains closed for entire visits
    • Regardless of symptoms or decision to test
FLOC/RN Team Assessment
Laboratory and Radiologic Testing
Including concern for tropical disease
RDT Not Applicable
Negative RDT
Positive RDT
  • Reassuring VS and PE
  • No significant anemia/hemolysis
  • Ability for PCP follow-up w/in 24 hrs
  • Child ill-appearing or
  • Neurologic signs/symptoms or
  • Significant anemia (Hgb < 7, evidence of hemolysis)

Reconsider 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 children
  • Ensure adequate hydration
  • Reassuring VS, PE
  • Fever care, specific discharge instructions
  • Follow-up recommendations
Posted: November 2021
Revised: March 2024
Editors: Clinical Pathways Team