Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • diarrhoea (with or without tenesmus), cramping, nausea, and vomiting
  • dysentery (blood and fever)
  • persistent diarrhoea >7 days

Other diagnostic factors

  • diarrhoea without illness

Risk factors

  • age <30 years
  • decreased stomach acidity
  • prior TD susceptibility, chronic disease, immune compromise
  • travellers with prior residence in developing country visiting friends and relatives
  • travel during the rainy season, or summer travel in Nepal

Diagnostic investigations

1st investigations to order

  • faecal leukocytes (WBC)
  • stool occult blood
  • stool culture and sensitivity
Full details

Investigations to consider

  • stool ova and parasite (O+P) examination
  • Giardia stool antigen
  • Clostridium difficile stool toxin
  • colonoscopy and biopsy
  • faecal calprotectin
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Emergency Medicine

West Virginia University School of Medicine

Morgantown

WV

Disclosures

GJ declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Pediatrics

Medical University of South Carolina

Charleston

SC

Disclosures

AS declares that she has no competing interests.

Professor of Pediatrics

Department of Pediatric and Adolescent Medicine

Mayo Clinic

Rochester

MN

Disclosures

PF is an author of a reference cited in this monograph.

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