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Traveler's diarrhea

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 17 Oct 2025
最后更新： 03 Sep 2024

小结

定义

病史和体格检查

关键诊断因素

  • diarrhea (with or without tenesmus), cramping, nausea, and vomiting
  • dysentery (blood and fever)
  • persistent diarrhea >14 days
完整详情

其他诊断因素

  • diarrhea without illness
完整详情

危险因素

  • 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
完整详情

诊断性检查

首要检查

  • stool culture and sensitivity
  • multipathogen molecular diagnostic (polymerase chain reaction)
  • protozoal stool antigens
完整详情

需考虑的检查

  • stool ova and parasite exam
  • Clostridioides difficile stool toxin
  • colonoscopy, endoscopy, and biopsy
  • hematology, blood chemistries, serology
完整详情

治疗流程

初步治疗

pretravel prophylaxis

pre-travel prophylaxis

急症处理

nonpregnant adults: mild diarrhea

nonpregnant adults: moderate diarrhea

nonpregnant adults: severe diarrhea

pregnant

children

撰稿人

作者

Daniel T. Leung, MD, MSc

Associate Professor

Division of Infectious Diseases

University of Utah School of Medicine

Salt Lake City

UT

利益声明

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

利益声明

JP declares that he has no competing interests.

鸣谢

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.

利益声明

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.

同行评议者

Andrea Summer, MD

Assistant Professor of Pediatrics

Medical University of South Carolina

Charleston

SC

利益声明

AS declares that she has no competing interests.

Phil Fischer, MD

Professor of Pediatrics

Department of Pediatric and Adolescent Medicine

Mayo Clinic

Rochester

MN

利益声明

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

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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.全文  摘要

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].全文

De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoea. Cochrane Database Syst Rev. 2000;(3):CD002242.全文  摘要

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. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • 鉴别诊断

    • Food poisoning
    • Irritable bowel syndrome
    • Secondary disaccharidase (or other dietary) deficiency
    更多 鉴别诊断

  • 指南

    • CDC Yellow Book 2024: travelers' diarrhea
    • 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea​
    更多 指南

  • 患者教育信息

    Diarrhea in adults

    更多 患者教育信息
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