Fake imported tropical diseases: A retrospective study

espanolIntroduccion. La evaluacion de un enfermo con sospecha de patologia importada debe incluir las causas autoctonas que puedan simular enfermedades importadas, para evitar un diagnostico erroneo y un retraso terapeutico. Metodos. Estudio retrospectivo longitudinal descriptivo de pacientes con sospecha de patologia importada con diagnostico final de proceso autoctono. Los pacientes fueron seleccionados en dos consultas especializadas en enfermedades tropicales de dos hospitales espanoles entre 2008-2017. Resultados. Se obtuvieron 16 pacientes, 11 (68,7%) hombres. La edad media fue de 43,4 ± 13,7 anos. Trece pacientes (81,2%) eran viajeros. Ocho (50%) pacientes eran latinoamericanos, 7 (43,5%) africanos y un paciente asiatico (6,2%). El tiempo desde el viaje hasta la evaluacion oscilo entre 1 semana y 20 anos. El tiempo medio desde la evaluacion hasta el diagnostico fue de 58,4 ± 100,9 dias. Hubo 5 (31,2%) casos de infeccion autoctona, 5 (31,2%) casos de cancer, 2 (12,5%) casos de enfermedad inflamatoria y 2 (12,5%) casos de patologia vascular. Conclusiones. El origen del paciente o el antecedente de un viaje pueden ser factores de confusion durante el proceso clinico y causar un retraso diagnostico y terapeutico. Por lo tanto, es aconsejable una vision amplia al evaluar estas enfermedades. Destacamos que un tercio de los pacientes presento un diagnostico final de neoplasia. Palabras clave: espanolBackground. When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. Methods. A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. Results. We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. Conclusions. Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis. Key words