Which etiologies of fever of unknown origin (FUO) are suggested by travel-related or environmental exposures?

Updated: May 17, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Travel-related and other environmental exposures are as follows:

  • Desert areas of the southwest United States, California: Coccidioides immitis infection
  • River valleys (Ohio, Mississippi, Central/South America): Histoplasma, Blastomyces infection
  • Caves (bats): Histoplasma infection
  • Swimming in rivers, fresh water, especially with rains: Leptospirosis
  • Rural Central/South America, Africa, Asia: Tuberculosis, especially extrapulmonary; malaria (in malaria-prone areas; travelers of developed countries may not seek pretravel advice or take malaria prophylaxis; malaria may manifest weeks to months after return home)
  • Mediterranean, tropics: Visceral leishmaniasis
  • United States, rodent-infested cabins: Borrelia hermsii (tick-borne relapsing fever), week-long fevers interrupted by week-long remissions
  • North America, Eurasia, tick-infested brush and forest: Borrelia miyamoto i
  • Middle East, Latin America, refugees, disrupted civil services in disaster or war, humanitarian aid workers: Borrelia recurrentis/Brucella melitensis (louse-borne relapsing fever)
  • Uncertain sanitation, adventurous eating: Salmonella typhi (typhoid)

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