BMJ Case Reports 2011; doi:10.1136/bcr.07.2011.4564
  • Learning from errors

The importance of a travel history in the preoperative assessment of an elective surgical patient

  1. Evangelos Efthimiou1
  1. 1Department of General surgery, Chelsea and Westminster Hospital, London, UK
  2. 2Department of Surgery, Royal Marsden Hospital, London, UK
  1. Correspondence to Dr Emily Han Shao, emilyhanshao{at}


The authors present the case of a 43-year-old gentleman who was admitted for an elective surgical removal of an eroded gastric band. The patient reported no medical concerns and other than a mild anaemia of haemoglobin of 10.6, his preoperative assessment was non-significant. Postoperatively, the patient spiked temperatures on multiple occasions. When a travel history was subsequently taken, the patient revealed he had returned from Nigeria the night before his elective surgery. The patient tested positive for Plasmodium falciparum malaria for which he was successfully managed with oral quinine and doxycycline, and recuperated well both from malaria and the surgery. P falciparum malaria is a medical emergency and increases the morbidity and mortality of anaesthesia and surgery. Travel histories are not currently routinely taken as part of the preoperative assessment for elective surgical admissions; the authors argue that it should become a mandatory part.


  • Competing interests None.

  • Patient consent Obtained.

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