Emergency department evaluation and management of serious and high-risk infections in the febrile returning traveler.

Fever in the returning international traveler presents a diagnostic challenge in the emergency department due to the wide range of potential infectious diseases that may be encountered abroad, many of which may manifest with nonspecific presentations. Malaria remains the most common and life-threatening tropical cause of fever and must be ruled out in all febrile patients returning from malaria-endemic regions. Other key infections to consider in returning travelers include dengue, enteric fever, and leptospirosis. Early recognition and treatment of these diseases can reduce morbidity and mortality and may help contain disease outbreaks. This review presents a structured, systematic approach to the timely evaluation of fever in returning international travelers, including evidence-based recommendations for the diagnosis and treatment of malaria, dengue, enteric fever, and leptospirosis.