So You Want to Work in the Tropics? Fever, Uncertainty, and Clinical Reasoning

What do you do when you’re deep in the tropics, it’s 38°C, and your patient has a fever—but you’re hours from the nearest lab or hospital?

In this session from the World Extreme Medicine Conference, Laura McArthur shares her field-tested approach to diagnosing and managing febrile patients in remote tropical environments. Drawing from her background in general practice, obstetrics and gynaecology, orthopaedics, and expedition medicine, she offers a grounded and flexible strategy that balances clinical logic with real-world constraints.

This is not a list of textbook differentials—it’s a practical, scenario-led guide to:

Building an effective approach when you don’t have the full clinical picture
Recognising red flags in tropical environments
Avoiding tunnel vision in symptom-heavy presentations
Applying structured decision-making when diagnostics are minimal
Lessons from remote mountain, ocean, and jungle expeditions

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Intended Learning Outcomes

By the end of this session, attendees will be able to:

Develop a structured clinical approach to fever in tropical and low-resource settings.
Understand how to balance broad differentials with operational realities.
Identify high-risk symptoms that require escalation or evacuation.
Apply pattern recognition and clinical reasoning without over-reliance on testing.
Reflect on the psychological impact of uncertainty in remote decision-making.