Table 2. Symptom-based overview of travel-related infectious fever syndromes, adapted from (21, e5, e8).

Fever syndrome	Common pathogens
Fever without local symptoms	● Malaria (especially sub-Saharan Africa) ● Dengue fever (especially Southeast Asia, South and Central America) ● Typhoid and paratyphoid fever (especially Indian subcontinent) ● Rickettsioses (especially sub-Saharan Africa)
Fever and rash (exanthema)	● Arboviral diseases (especially dengue, Chikungunya, Zika, and West Nile fever) ● Viral HF, e.g. Ebola HF, Marburg HF ● Measles, rubella, chickenpox, herpes zoster generalisatus (worldwide) ● Acute HIV, EBV, CMV infection (mononucleosis syndrome) ● Rickettsioses (eschar, rash); relapsing fever (especially tick-borne relapsing fever) ● Typhoid fever (rose spots), syphilis (stage II) ● African trypanosomiasis; acute schistosomiasis (urticaria) ● Strongyloidiasis (urticaria, larva currens), trichinellosis (urticaria)
Fever and respiratory symptoms	● Influenza, COVID-19 (SARS-CoV-2) (worldwide) ● MERS (MERS-CoV) (Arabian Peninsula) ● Legionellosis (e.g., after cruise trip) ● Melioidosis (especially Southeast Asia) ● Tuberculosis (VFR, HCW), Q fever, psittacosis, leptospirosis ● Acute histoplasmosis and coccidioidomycosis ● Löffler syndrome and tropical pulmonary eosinophilia (helminth infection)
Fever and diarrhea	● Traveler‘s diarrhea, especially due to infection with ETEC, EAEC, EPEC, campylobacteriosis, salmonellosis, shigellosis, very rarely cholera ● Norovirus, rotavirus enteritis (e.g., outbreaks on cruise ships) ● Lambliasis/giardiasis, cryptosporidiosis (watery diarrhea) ● Amoebic colitis (bloody diarrhea) ● Malaria (in approx. 30% of cases watery diarrhea) ● Typhoid fever (diarrhea starting week 2–3 of the disease)
Fever and abdominal pain	● Typhoid/paratyphoid fever ● Lambliasis/giardiasis, cryptosporidiosis (upper abdominal pain, meteorism, nausea) ● Pyogenic liver abscess or amebic liver abscess (hepatomegaly) ● Brucellosis, malaria, visceral leishmaniosis (kala-azar), infectious mononucleosis (splenomegaly) ● Relapsing fever (hepatosplenomegaly)
Fever and icterus	● Severe malaria (hemolysis), hepatitis A-E ● Viral HF (yellow fever, Crimean–Congo HF, Rift Valley fever, severe dengue fever) ● Leptospirosis (Weil‘s disease); bartonellosis (Oroya fever), HUS (e.g., EHEC) ● Acute cholangitis (e.g., liver fluke infection)
Fever and hepatitis	● Hepatitis A-E, dengue fever ● Acute CMV, EBV, HIV, toxoplasma gondii infection (mononucleosis syndrome) ● Q fever, brucellosis, leptospirosis
Fever and neurological symptoms	● Bacterial meningitis (e.g., meningococcal, TB), typhoid/paratyphoid fever, neurosyphilis ● Viral encephalitis (e.g., due to HSV, VZV, JE, WNV, dengue virus, rabies virus, measles, enteroviruses) ● Cerebral malaria, African trypanosomiasis (sleeping sickness) ● Angiostrongyliasis, gnathostomiasis (eosinophilic meningitis)
Fever and signs of bleeding (purpura)	● Sepsis (meningococcal, staphylococcal, streptococcal), rickettsioses, leptospirosis, plague ● HF (e.g., Crimean-Congo HF, Ebola HF, Marburg HF, dengue HF, yellow fever)
Fever and eosinophilia	● Helminth infection, especially acute schistosomiasis, ascariasis, ancylostomiasis (hook worms), strongyloidiasis (Strongyloides stercoralis), fascioliasis (Fasciola hepatica), visceral larva migrans (toxocariasis), filariasis, trichinellosis
Fever and arthralgia or myalgia	● Chikungunya fever, dengue fever, Zika fever, Ross River fever (Australia), muscular sarcocystosis (Southeast Asia), trichinellosis

CMV, cytomegalovirus; EAEC, enteroaggregative E. coli; EBV, Epstein-Barr virus; EHEC, enterohemorrhagic E. coli; EPEC, enteropathogenic E. coli; ETEC, enterotoxigenic E. coli;

HCW, health care worker; HF, hemorrhagic fever; HIV, human immunodeficiency virus; HSV, herpes simplex virus; HUS, hemolytic uremic syndrome; JE, Japanese encephalitis;

MERS-CoV, Middle East Respiratory Syndrome coronavirus; SARS-CoV-2, Severe Acute Respiratory Syndromecoronavirus type 2; TB, tuberculosis; VFR, visiting friends and relatives; VZV, varicella zoster virus; WNV, West Nile virus