Return from the tropics: relevant diagnosis and rational therapy

Gastrointestinal disorders, particularly diarrhoea, are the main reason to consult a physician after travelling to the tropics. Although mostly of infectious origin specific pathogens frequently cannot be demonstrated. As the majority of acute diarrhoeal episodes resolve without any specific therapy, bacterological and parasitological investigations should initially be ordered with reserve and economically. Fever after a stay in the tropics has to be always a matter of concern as it could be the expression of a potentially dangerous infection, e.g. falciparum malaria. The primary objective must be the exclusion of potentially life-threatening infections requiring a specific treatment. Numerous asymptomatic travellers returning from the tropics want their physicians to exclude an inapparent exotic infection. The value of such check-ups can be questioned, and there are just a few rational investigations in this particular context.