Journal of travel medicine
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We present a case of melioidosis in an Italian male returning from Singapore after a short travel. He probably acquired the disease by inhalation, which is not the typical mode of transmission, in the absence of evident risk factors. The diagnosis was confirmed by real-time polymerase chain reaction of the culture while serology was useful to assess professional exposure among laboratory workers. Treatment consisted of an initial intensive phase with meropenem and trimethoprim-sulfamethaxazole (TMP-SMX), followed by 6 months of eradication therapy with TMP-SMX.
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Existing travel health guidelines are based on a variety of data with underpinning evidence ranging from high-quality randomized controlled trials to best estimates from expert opinion. For strategic guidance and to set overall priorities, data about average risk are useful. The World Health Organization (WHO) plans to base future editions of "International Travel and Health" on its new "Handbook for Guideline Development." ⋯ In order for the WHO to produce graded risk statements in the updated version of "International Travel and Health," major investment of time plus additional high-quality, generalizable risk data are needed.
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A woman stung by the box jellyfish Carybdea marsupialis (Cnidaria, Cubozoa) at a Spanish Mediterranean beach showed systemic manifestations over several months [pain far from the inoculation point, arthralgia, paresthesia, hyperesthesia, increase in eosinophils and immunoglobulin E (IgE)] in addition to the skin condition.
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It has been recommended that numerical risk data should be provided during the pre-travel consultation in order for travelers to make informed decisions regarding uptake of preventive interventions. ⋯ Travel health practitioners should be aware of the complexities, limitations, and difficulties in understanding numerical risk data, as these factors are important in travelers' acceptance or rejection of interventions offered.
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Hemophagocytic syndrome (HPS) can develop as a complication of dengue in rare cases, but its relationship with dengue is not well known. We report a case of dengue-associated HPS with liver involvement and coagulopathy. The patient, a Japanese female traveler who had recently returned from Thailand, had severe complications of dengue infection, but she recovered fully with symptomatic treatment.