Summary
Definition
History and exam
Key diagnostic factors
- diarrhea (with or without tenesmus), cramping, nausea, and vomiting
- dysentery (blood and fever)
- persistent diarrhea >14 days
Other diagnostic factors
- diarrhea without illness
Risk factors
- travel to a high-risk destination
- age <30 years
- proton-pump inhibitor use
- travelers with prior residence in higher-risk destination visiting friends and relatives
- travel during hot and wet seasons
- deployed military populations
- lack of caution in food and water selection
Diagnostic tests
Primeras pruebas diagnósticas para solicitar
- stool culture and sensitivity
- multipathogen molecular diagnostic (polymerase chain reaction)
- protozoal stool antigens
Pruebas diagnósticas que deben considerarse
- stool ova and parasite exam
- Clostridioides difficile stool toxin
- colonoscopy, endoscopy, and biopsy
- hematology, blood chemistries, serology
Algoritmo de tratamiento
pretravel prophylaxis
pre-travel prophylaxis
nonpregnant adults: mild diarrhea
nonpregnant adults: moderate diarrhea
nonpregnant adults: severe diarrhea
pregnant
children
Colaboradores
Autores
Daniel T. Leung, MD, MSc
Associate Professor
Division of Infectious Diseases
University of Utah School of Medicine
Salt Lake City
UT
Divulgaciones
DTL receives authorship royalties from UpToDate, Inc, for a chapter on travel medicine. DTL is an author of upcoming chapters on traveler's diarrhea for the US CDC Yellow Book. DTL is the president-elect of the American Committee on Clinical Tropical Medicine and Travelers' Health - Clinical Group within the American Society of Tropical Medicine and Hygiene. DTL is an author of some of the references cited in this topic.
Jakrapun Pupaibool, MD, MS
Associate Professor
Division of Infectious Diseases
University of Utah School of Medicine
Salt Lake City
UT
Divulgaciones
JP declares that he has no competing interests.
Agradecimientos
Dr Daniel T. Leung and Dr Jakrapun Pupaibool would like to gratefully acknowledge Dr Mark Riddle and Professor Gregory Juckett, the previous contributor to this topic.
Divulgaciones
MR has given talks on the management of traveler's diarrhea for the International Society of Travel Medicine (ISTM), the CDC Foundation, the American College of Gastroenterology (ACG), and the American College of Preventive Medicine. MR has led the development of guidelines for traveler's diarrhea for the ISTM, the ACG, and the Department of Defense. This work has been unpaid but support for travel has been accepted. MR is employed with Pfizer Inc., and is working on their Lyme disease vaccine program. While this is not in conflict with traveler’s diarrhea, Pfizer also makes azithromycin, which is an antibiotic recommended for the treatment of traveler’s diarrhea. MR does not work in the area of Pfizer that develops, markets, or distributes azithromycin. MR is an author of several references cited in this topic. GJ declares that he has no competing interests.
Revisores por pares
Andrea Summer, MD
Assistant Professor of Pediatrics
Medical University of South Carolina
Charleston
SC
Divulgaciones
AS declares that she has no competing interests.
Phil Fischer, MD
Professor of Pediatrics
Department of Pediatric and Adolescent Medicine
Mayo Clinic
Rochester
MN
Divulgaciones
PF is an author of a reference cited in this topic.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Riddle MS, Connor BA, Beeching NJ, et al. Guidelines for the prevention and treatment of travelers' diarrhea: a graded expert panel report. J Travel Med. 2017 Apr 1;24(suppl 1):S57-74.Texto completo Resumen
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 2: preparing international travelers - travelers’ diarrhea. May 2023 [internet publication].Texto completo
De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoea. Cochrane Database Syst Rev. 2000;(3):CD002242.Texto completo Resumen
Johnson PC, Ericsson CD, DuPont HL, et al. Comparison of loperamide with bismuth subsalicylate for the treatment of acute travelers' diarrhea. JAMA. 1986 Feb 14;255(6):757-60. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Food poisoning
- Irritable bowel syndrome
- Secondary disaccharidase (or other dietary) deficiency
Más DiferencialesGuías de práctica clínica
- CDC Yellow Book 2024: travelers' diarrhea
- 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea
Más Guías de práctica clínicaFolletos para el paciente
Diarrhea in adults
Más Folletos para el paciente
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