Skip to main content

Advertisement

Log in

Cutaneous Manifestations of Infection in Returning Travelers

  • Skin, Soft Tissue, Bone and Joint Infectious Diseases (N Safdar, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Dermatologic problems are common in returning travelers who seek medical care. Some common illnesses such as cellulitis or abscesses occur in travelers but are not unique to this patient group. Additionally, dermatologic illnesses not due to infection such as drug eruptions or phototoxicity are seen. Skin manifestations occur in many tropical illnesses such as dengue, schistosomiasis, and leishmaniasis. This article reviews the common causes of cutaneous illnesses associated with travel including non-infectious causes, infections that are not limited to travelers, and infections that are almost exclusively seen in travelers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. United Nations World Tourism Organization (UNWTO) World Tourism Barometer. Edited by; 2014.

  2. Leder K, Torresi J, Libman MD, Cramer JP, Castelli F, Schlagenhauf P, et al. GeoSentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med. 2013;158:456–68. This review highlights the most recently reported information from the GeoSentinel surveillance program, including breakdown of diseases by region and clinical manifestation.

    Article  PubMed  Google Scholar 

  3. Van Herck K, Van Damme P, Castelli F, Zuckerman J, Nothdurft H, Dahlgren AL, et al. Knowledge, attitudes and practices in travel-related infectious diseases: the European airport survey. J Travel Med. 2004;11:3–8.

    Article  PubMed  Google Scholar 

  4. Hamer DH, Connor BA. Travel health knowledge, attitudes and practices among United States travelers. J Travel Med. 2004;11:23–6.

    Article  PubMed  Google Scholar 

  5. Baaten GG, Geskus RB, Kint JA, Roukens AH, Sonder GJ, van den Hoek A. Symptoms of infectious diseases in immunocompromised travelers: a prospective study with matched controls. J Travel Med. 2011;18:318–26.

    Article  PubMed  Google Scholar 

  6. Lortholary O, Charlier C, Lebeaux D, Lecuit M, Consigny PH. Fungal infections in immunocompromised travelers. Clin Infect Dis. 2013;56:861–9. This review describes the different types of immunocompromised travelers and their risk for fungal infections, along with manifestations of different fungal infections. In addition, it provides quality maps on the natural distribution of histoplasmosis, coccidioidomycosis, cryptococcosis and penicilliosis.

    Article  PubMed  Google Scholar 

  7. Hochberg NS, Barnett ED, Chen LH, Wilson ME, Iyer H, MacLeod WB, et al. International travel by persons with medical comorbidities: understanding risks and providing advice. Mayo Clin Proc. 2013;88:1231–40.

    Article  PubMed  Google Scholar 

  8. Lederman ER, Weld LH, Elyazar IR, von Sonnenburg F, Loutan L, Schwartz E, et al. Dermatologic conditions of the ill returned traveler: an analysis from the GeoSentinel Surveillance Network. Int J Infect Dis. 2008;12:593–602.

    Article  PubMed  Google Scholar 

  9. Kutlubay Z, Sevim A, Engin B, Tuzun Y. Photodermatoses, including phototoxic and photoallergic reactions (internal and external). Clin Dermatol. 2014;32:73–9.

    Article  PubMed  Google Scholar 

  10. Sunenshine PJ, Schwartz RA, Janniger CK. Tinea versicolor. Int J Dermatol. 1998;37:648–55.

    Article  PubMed  CAS  Google Scholar 

  11. Hart CA, Cuevas LE. Meningococcal disease in Africa. Ann Trop Med Parasitol. 1997;91:777–85.

    Article  PubMed  CAS  Google Scholar 

  12. Taha MK, Achtman M, Alonso JM, Greenwood B, Ramsay M, Fox A, et al. Serogroup W135 meningococcal disease in Hajj pilgrims. Lancet. 2000;356:2159.

    Article  PubMed  CAS  Google Scholar 

  13. Chosidow O. Clinical practices. Scabies. N Engl J Med. 2006;354:1718–27.

    Article  PubMed  CAS  Google Scholar 

  14. Fuller LC. Epidemiology of scabies. Curr Opin Infect Dis. 2013;26:123–6.

    Article  PubMed  Google Scholar 

  15. Drabick JJ, Lupton GP, Tompkins K. Crusted scabies in human immunodeficiency virus infection. J Am Acad Dermatol. 1987;17:142.

    Article  PubMed  CAS  Google Scholar 

  16. Centers for Disease C, Prevention. Notes from the field: measles outbreak associated with a traveler returning from India—North Carolina, April–May 2013. MMWR Morb Mortal Wkly Rep. 2013;62:753.

    Google Scholar 

  17. Moss WJ, Griffin DE. Measles. Lancet. 2012;379:153–64.

    Article  PubMed  Google Scholar 

  18. Centers for Disease C, Prevention. Measles—United States, January 1–August 24, 2013. MMWR Morb Mortal Wkly Rep. 2013;62:741–3.

    Google Scholar 

  19. Davis BA. Sporotrichosis. Dermatol Clin. 1996;14:69–76.

    Article  PubMed  CAS  Google Scholar 

  20. DiCaudo DJ. Coccidioidomycosis: a review and update. J Am Acad Dermatol. 2006;55:929–42. quiz 943-925.

    Article  PubMed  Google Scholar 

  21. Saccente M, Woods GL. Clinical and laboratory update on blastomycosis. Clin Microbiol Rev. 2010;23:367–81.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Goodwin Jr RA, Shapiro JL, Thurman GH, Thurman SS, Des Prez RM. Disseminated histoplasmosis: clinical and pathologic correlations. Medicine (Baltimore). 1980;59:1–33.

    Article  Google Scholar 

  23. Wheat J. Histoplasmosis: recognition and treatment. Clin Infect Dis. 1994;19 Suppl 1:S19–27.

    Article  PubMed  Google Scholar 

  24. Supparatpinyo K, Chiewchanvit S, Hirunsri P, Uthammachai C, Nelson KE, Sirisanthana T. Penicillium marneffei infection in patients infected with human immunodeficiency virus. Clin Infect Dis. 1992;14:871–4.

    Article  PubMed  CAS  Google Scholar 

  25. Kenyon C, Bonorchis K, Corcoran C, Meintjes G, Locketz M, Lehloenya R, et al. A dimorphic fungus causing disseminated infection in South Africa. N Engl J Med. 2013;369:1416–24. This articles describes the clinical and mycologic features of a newly identified disseminated fungal infection among patients with advanced HIV in South Africa.

    Article  PubMed  CAS  Google Scholar 

  26. Matteelli A, Carosi G. Sexually transmitted diseases in travelers. Clin Infect Dis. 2001;32:1063–7.

    Article  PubMed  CAS  Google Scholar 

  27. Ansart S, Hochedez P, Perez L, Bricaire F, Caumes E. Sexually transmitted diseases diagnosed among travelers returning from the tropics. J Travel Med. 2009;16:79–83.

    Article  PubMed  Google Scholar 

  28. Rice B, Gilbart VL, Lawrence J, Smith R, Kall M, Delpech V. Safe travels? HIV transmission among Britons travelling abroad. HIV Med. 2012;13:315–7.

    Article  PubMed  CAS  Google Scholar 

  29. Vanhems P, Voirin N, Hirschel B, Cooper DA, Vizzard J, Carr A, et al. Brief report: incubation and duration of specific symptoms at acute retroviral syndrome as independent predictors of progression to AIDS. J Acquir Immune Defic Syndr. 2003;32:542–4.

    Article  PubMed  Google Scholar 

  30. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med. 2006;354:119–30.

    Article  PubMed  CAS  Google Scholar 

  31. Centers for Disease C, Prevention. Locally acquired Dengue—Key West, Florida, 2009–2010. MMWR Morb Mortal Wkly Rep. 2010;59:577–81.

    Google Scholar 

  32. Wilder-Smith A, Schwartz E. Dengue in travelers. N Engl J Med. 2005;353:924–32.

    Article  PubMed  CAS  Google Scholar 

  33. Pialoux G, Gauzere BA, Jaureguiberry S, Strobel M. Chikungunya, an epidemic arbovirosis. Lancet Infect Dis. 2007;7:319–27.

    Article  PubMed  Google Scholar 

  34. de Andrade DC, Jean S, Clavelou P, Dallel R, Bouhassira D. Chronic pain associated with the Chikungunya Fever: long lasting burden of an acute illness. BMC Infect Dis. 2010;10:31.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Raoult D, Fournier PE, Fenollar F, Jensenius M, Prioe T, de Pina JJ, et al. Rickettsia africae, a tick-borne pathogen in travelers to sub-Saharan Africa. N Engl J Med. 2001;344:1504–10.

    Article  PubMed  CAS  Google Scholar 

  36. Jensenius M, Fournier PE, Raoult D. Tick-borne rickettsioses in international travellers. Int J Infect Dis. 2004;8:139–46.

    Article  PubMed  Google Scholar 

  37. Ochiai RL, Wang X, von Seidlein L, Yang J, Bhutta ZA, Bhattacharya SK, et al. Salmonella paratyphi A rates, Asia. Emerg Infect Dis. 2005;11:1764–6.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Infect Dis. 2010;50:241–6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Corachan M. Schistosomiasis and international travel. Clin Infect Dis. 2002;35:446–50.

    Article  PubMed  Google Scholar 

  40. Clerinx J, Van Gompel A. Schistosomiasis in travellers and migrants. Travel Med Infect Dis. 2011;9:6–24.

    Article  PubMed  Google Scholar 

  41. Ross AG, Vickers D, Olds GR, Shah SM, McManus DP. Katayama syndrome. Lancet Infect Dis. 2007;7:218–24.

    Article  PubMed  Google Scholar 

  42. Kolarova L, Horak P, Skirnisson K, Mareckova H, Doenhoff M. Cercarial dermatitis, a neglected allergic disease. Clin Rev Allergy Immunol. 2013;45:63–74.

    Article  PubMed  CAS  Google Scholar 

  43. Herwaldt BL. Leishmaniasis. Lancet. 1999;354:1191–9.

    Article  PubMed  CAS  Google Scholar 

  44. Convit J, Ulrich M, Fernandez CT, Tapia FJ, Caceres-Dittmar G, Castes M, et al. The clinical and immunological spectrum of American cutaneous leishmaniasis. Trans R Soc Trop Med Hyg. 1993;87:444–8.

    Article  PubMed  CAS  Google Scholar 

  45. Brenner MA, Patel MB. Cutaneous larva migrans: the creeping eruption. Cutis. 2003;72:111–5.

    PubMed  Google Scholar 

  46. Jelinek T, Maiwald H, Nothdurft HD, Loscher T. Cutaneous larva migrans in travelers: synopsis of histories, symptoms, and treatment of 98 patients. Clin Infect Dis. 1994;19:1062–6.

    Article  PubMed  CAS  Google Scholar 

  47. Krajewski A, Allen B, Hoss D, Patel C, Chandawarkar RY. Cutaneous myiasis. J Plast Reconstr Aesthet Surg. 2009;62:e383–6.

    Article  PubMed  Google Scholar 

  48. Fernandes LF, Pimenta FC, Fernandes FF. First report of human myiasis in GoiaS state, Brazil: frequency of different types of myiasis, their various etiological agents, and associated factors. J Parasitol. 2009;95:32–8.

    Article  PubMed  Google Scholar 

  49. Francesconi F, Lupi O. Myiasis. Clin Microbiol Rev. 2012;25:79–105.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Boggild AK, Keystone JS, Kain KC. Furuncular myiasis: a simple and rapid method for extraction of intact Dermatobia hominis larvae. Clin Infect Dis. 2002;35:336–8.

    Article  PubMed  Google Scholar 

  51. Lefebvre M, Capito C, Durant C, Hervier B, Grossi O. Tungiasis: a poorly documented tropical dermatosis. Med Mal Infect. 2011;41:465–8.

    Article  PubMed  CAS  Google Scholar 

  52. Klion AD, Massougbodji A, Sadeler BC, Ottesen EA, Nutman TB. Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation. J Infect Dis. 1991;163:1318–25.

    Article  PubMed  CAS  Google Scholar 

  53. Padgett JJ, Jacobsen KH. Loiasis: African eye worm. Trans R Soc Trop Med Hyg. 2008;102:983–9.

    Article  PubMed  Google Scholar 

  54. Gupta A, Kedhar S. Images in clinical medicine. Eye worm. N Engl J Med. 2005;353:e22.

    Article  PubMed  Google Scholar 

  55. Rusnak JM, Lucey DR. Clinical gnathostomiasis: case report and review of the English-language literature. Clin Infect Dis. 1993;16:33–50.

    Article  PubMed  CAS  Google Scholar 

  56. Herman JS, Chiodini PL. Gnathostomiasis, another emerging imported disease. Clin Microbiol Rev. 2009;22:484–92.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Wilson ME, Weld LH, Boggild A, Keystone JS, Kain KC, von Sonnenburg F, et al. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis. 2007;44:1560–8.

    Article  PubMed  Google Scholar 

  58. Keri JE, Thomas K, Berman B, Falabella A. Purpura fulminans in a patient with malaria. Eur J Dermatol. 2000;10:617–9.

    PubMed  CAS  Google Scholar 

  59. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis. 2003;3:757–71.

    Article  PubMed  Google Scholar 

  60. Klevens RM, Miller JT, Iqbal K, Thomas A, Rizzo EM, Hanson H, et al. The evolving epidemiology of hepatitis a in the United States: incidence and molecular epidemiology from population-based surveillance, 2005–2007. Arch Intern Med. 2010;170:1811–8.

    Article  PubMed  Google Scholar 

  61. Kappus MR, Sterling RK. Extrahepatic manifestations of acute hepatitis B virus infection. Gastroenterol Hepatol (N Y). 2013;9:123–6.

    Google Scholar 

  62. Teshale EH, Hu DJ, Holmberg SD. The two faces of hepatitis E virus. Clin Infect Dis. 2010;51:328–34.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Stuart Cohen and Matthew Eldridge declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stuart H. Cohen.

Additional information

This article is part of the Topical Collection on Skin, Soft Tissue, Bone and Joint Infectious Diseases

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eldridge, M., Cohen, S.H. Cutaneous Manifestations of Infection in Returning Travelers. Curr Infect Dis Rep 16, 426 (2014). https://doi.org/10.1007/s11908-014-0426-9

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11908-014-0426-9

Keywords

Navigation