Background.

In today's mobile society, international travel and immigration are becoming increasingly more common. This poses an additional challenge to the clinician to expand the differential diagnosis to include diseases endemic to the area of travel.

Observation.

We present a case of malaria and tuberculosis in a 16-year-old African male immigrant. He had several encounters with the health care system for complaints of nonspecific symptoms for which he was treated with antibiotics without follow-up.

Conclusion.

Clinicians should take a complete history and expand their differential diagnosis to include diseases endemic to the country of origin and/or travel when treating an international patient. This not only will allow prompt treatment of the patient's condition but also will address public health concerns.

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