Pavani Reddy, MD

Most travelers to third-world countries encounter healthrelatedproblems during their stay and may require medicalattention on returning home. Although malaria is still themost common diagnosis among travelers to the developingworld, several other infectious diseases, such as avian influenza,dengue fever, chikungunya fever, leishmaniasis, andmultidrug-resistant tuberculosis, are growing in importance.Clinicians need to stay informed about travel requirementsand vaccine recommendations for US citizens. [Infect Med.2008;25:352-386]

ABSTRACT: When a solitary lung nodule is detected, the key question is whether the lesion is malignant. The initial evaluation includes a careful history taking focused on risk factors for malignancy, a thorough physical examination, comparison of current chest films with previous ones, and CT scanning. Radiologic signs that suggest malignancy include lesion size greater than 2 cm in diameter, spiculated margins, lack of calcification, and change in size. Video-assisted thoracoscopic surgery or thoracotomy is the next step for patients with a suspected malignant lesion. If the results of the initial evaluation are equivocal, positron emission tomography (PET) scanning is the preferred follow-up.