Imported Exotic Infectious Diseases in Columbia, Missouri
Methods: From the Geo-sentinel master list, we created a sublist of exotic infections acquired outside of the United States of America (USA) and performed a retrospective chart review for patients with one or more of these diagnoses. Inclusion criteria: Patients seen by the Division of Infectious Diseases from Jan 2001 to Jan 2014, who had a diagnosis of an imported exotic infection and 18 years or older. We abstracted demographic data, travel history, clinical findings, and laboratory results.
Results: We recorded 38 cases of exotic infections. Tuberculosis (TB) was seen in 17 patients with one or more of the following: 4 lymphadenopathy, 4 gastrointestinal, 7 pulmonary, 2 each disseminated and latent TB, and 1 each of genitourinary and spine TB. There was no specific geographical trend: 3 Central America (CA), 4 Asia, 4 Africa, 2 Oceania and 1 Europe; 3 TB cases also had HIV and 1 had Echinococcosis. The remaining cases were diverse in diagnoses and origins: Africa: 4 cases of malaria (3 Africa, 1 Sri Lanka) and 1 each of typhoid (Ghana), paratyphoid (Sierra Leone), giardiasis (Sudan), loa loa (Gabon) and schistosomiasis (West Africa); Asia: 1 each of typhoid (Nepal), Leprosy (Sri Lanka), viral hepatitis A (Bangladesh), Japanese encephalitis (Thailand) and chronic Q fever (Iraq); CA: 2 cases each of neuro-cysticercosis (Mexico) and HTLV-1 (Mexico); 1 each of giardiasis (Ecuador), Chagas disease (El Salvador) and brucellosis (Mexico).
Conclusion: Like travelers and immigrants from coastal and urban USA settings, rural Midwest travelers and immigrants can present with a wide variety of foreign exotic infections. Knowledge of the variety and types of such infections is important for the education and training of health care providers; evaluation of ill patients; and preventive medicine for travelers.
U. A. Halai, None
D. Sirigeere Prabhakar, None
W. Roland, None
N. Havens, None
G. Christensen, None
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