[Infections of the lungs in returning travellers]

Abstract

Travellers to foreign countries can acquire infections with pathogens that are not endemic in Germany. In light of the steadily increasing foreign travel these infections in returning travellers are of growing importance. Older travellers and those with underlying diseases constitute a special risk group. The knowledge of pathogens endemic to foreign countries and of the respective clinical picture is essential for determining a suspected diagnosis, especially in patients not responding to a first empirical antibacterial treatment. The documentation of a thorough travel history is crucial for taking a possible exposure to specific pathogens into account and thus for guiding the diagnostic pathway. In addition to pathogens which primarily lead to an infection of the lungs, non-pulmonary infections, which can cause pulmonary symptoms, e.g. schistosomiasis and malaria also have to be considered. Two examples of infectious diseases of the lungs, which can only be acquired abroad, are melioidosis and coccidioidomycosis. While a pulmonary manifestation of melioidosis can take an acute and fulminant course associated with a high mortality rate, coccidioidomycosis primarily presents mostly as oligosymptomatic, but with a substantial latent period can lead to pulmonary manifestations that in their diversity resemble tuberculosis or malignancies.

Keywords: Coccidioidomycosis; Foreign travel; Melioidosis; Rare pulmonary infections; Travel history.