Abstract
Background
Although respiratory tract infections represent a frequent cause of morbidity in travelers, and pneumonia a frequent cause of medical consultation among febrile travelers returning home, the etiologic spectrum of pneumonia in travelers has not been specifically studied.
Methods
We reviewed the medical charts of all travelers hospitalized during a 12-month period in our department with pneumonia after returning home.
Results
Seventeen patients (nine men, eight women, mean age 44 years, range 26 to 67 years) were included in this study. The etiology of pneumonia was established in 13 patients. Bacterial pneumonia was documented in 10 cases and was due to Streptococcus pneumoniae (n = 2), Mycoplasma pneumoniae (n = 2), Legionella pneumophila (n = 1), Coxiella burnetti (n = 1), Leptospira sp. (n = 1) or Mycobacterium tuberculosis (n = 3). Other etiologies included histoplasmosis, invasive schistosomiasis and dengue fever (one case each).
Conclusion
These results show the wide range of causes of pneumonia among travelers returning from abroad.
Footnotes
The authors had no financial or other conflicts of interest to disclose.
References
- 1. Caumes E, Brucker G, Brousse G. et al. Travel-associated illness in 838 French tourists in Nepal in 1984. Travel Med Int 1991; 8: 72–76. [Google Scholar]
- 2. O'Brien D, Tobin S, Brown V. et al. Fever in returned travelers: review of hospital admissions for a 3-year period. Clin Infect Dis 2001; 33: 603–609. 11486283 [DOI] [PubMed] [Google Scholar]
- 3. Doherty JF, Grant AD, Bryceson ADM. Fever as the presenting complaint of travellers returning from the tropics. Q J Med 1995; 88: 277–281. [PubMed] [Google Scholar]
- 4. MacPherson DW, Guérillot F, Streiner DL. et al. Death and dying abroad: the Canadian experience. J Travel Med 2000; 07: 227–233. 11231205 [DOI] [PubMed] [Google Scholar]
- 5. Scott JAG, Hall AJ, Muyodi C. et al. Aetiology, outcome, and risk factors for mortality among adults with acute pneumonia in Kenya. Lancet 2000; 355: 1–15. 10615876 [DOI] [PubMed] [Google Scholar]
- 6. Joseph C, Morgan D, Birtles R. et al. An international investigation of an outbreak of legionnaires disease among UK and French tourists. Eur J Epidemiol 1996; 12: 215–219. 8884186 [DOI] [PubMed] [Google Scholar]
- 7. Jernigan DB, Hofmann J, Cetron MS. et al. Outbreak of Legionnaire's disease among cruise ship passengers exposed to a contaminated whirlpool spa. Lancet 1996; 347: 494–499. 8596266 [DOI] [PubMed] [Google Scholar]
- 8. Edelstein PH, Cetron MS. Editorial response: sea, wind, and pneumonia. Clin Infect Dis 1999; 28: 39–41. 10028068 [DOI] [PubMed] [Google Scholar]
- 9. Cobelens FGJ, Van Deutekom H, Draayer-Jansen IWE. et al. Risk of infection with Mycobacterium tuberculosis in travellers to areas of high tuberculosis endemicity. Lancet 2000; 356: 461–465. 10981889 [DOI] [PubMed] [Google Scholar]
- 10. Kenyon TA, Valway SE, Ihle W. et al. Transmission of multidrugresistant Mycobacterium tuberculosis during a long airplane flight. N Engl J Med 1996; 334: 933–938. 8596593 [DOI] [PubMed] [Google Scholar]
- 11. Witt MD. Editorial response: trains, travel, and tubercle. Clin Infect Dis 1999; 28: 57–58. 10028072 [DOI] [PubMed] [Google Scholar]
- 12. Moore M, Valway SE, Ihle W. et al. A train passenger with pulmonary tuberculosis: evidence of limited transmission during travel. Clin Infect Dis 1999; 28: 52–56. 10028071 [DOI] [PubMed] [Google Scholar]
- 13. Baret M, Klement E, dos Santos G. et al. Pneumopathie à Coxiella burnetti au retour de Guyane française. Bull Soc Pathol Exot 2000; 93: 325–327. 11775317 [PubMed] [Google Scholar]
- 14. Nelson ER. Haemorrhagic fever in children in Thailand. J Paediatr 1960; 56: 101–108. [DOI] [PubMed] [Google Scholar]
- 15. Khan AS, Young JC. Hantavirus pulmonary syndrome: at the crossroads. Curr Opin Infect Dis 2001; 14: 205–209. 11979134 [DOI] [PubMed] [Google Scholar]
- 16. Wenzel RP. Airline travel and infection. N Engl J Med 1996; 334: 981–982. 8596601 [DOI] [PubMed] [Google Scholar]
- 17. Miller JM, Tam TWS, Maloney S. et al. Cruise ships: high-risk passengers and the global spread of new influenza viruses. Clin Infect Dis 2000; 31: 433–438. 10987701 [DOI] [PubMed] [Google Scholar]
- 18. Marx A, Tavernini M, Gregory V. et al. Influenza virus infection in travellers to developing countries [abstract FC05.01]. Abstracts of the 8th Conference of the International Society of Travel Medicine, New York 2003. Stone Mountain, GA ISTM; 108. [Google Scholar]
- 19. Update: outbreak of severe acute respiratory syndrome—Worldwide, 2003. MMWR 2003; 52: 241–248. [PubMed] [Google Scholar]
- 20. Salomon J, Flament Saillour M, De Truchis P. et al. An outbreak of acute pulmonary histoplasmosis in members of a trekking trip in Martinique, French West Indies. J Travel Med 2003; 10: 87–93. 12650650 [DOI] [PubMed] [Google Scholar]
- 21. Casey KR. Atypical pneumonia and environmental factors—where have you been and what have you done Clin Chest Med 1991; 12: 285–302. 1855372 [PubMed] [Google Scholar]
- 22. Ansart S, Caumes E. Pneumonie au retour de voyages. Rev Mal Respir 2002; 19: 693–697. 12524487 [PubMed] [Google Scholar]
- 23. Visser LG, Polderman AM, Stuiver PC. Outbreak of schistosomiasis among travelers returning from Mali, West Africa. Clin Infect Dis 1995; 20: 280–285. 7742430 [DOI] [PubMed] [Google Scholar]
- 24. Joubert JJ, Evans AC, Schutte CH. Schistosomiasis in Africa and international travel. J Travel Med 2001; 8: 92–99. 11285168 [DOI] [PubMed] [Google Scholar]
- 25. Hirsh J, O'Donnell MJ. Venous thromboembolism after long flights: are airlines to blame Lancet 2001; 357: 1461–1462. 11377591 [DOI] [PubMed] [Google Scholar]