Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- diarreia (com ou sem tenesmo), cólicas, náuseas e vômitos
- disenteria (sangue e febre)
- diarreia persistente por >14 dias
Outros fatores diagnósticos
- diarreia sem doença
Fatores de risco
- viagem para um destino de alto risco
- idade <30 anos
- uso de inibidor da bomba de prótons
- viajantes com residência prévia em um local de alto risco visitando amigos e parentes
- viagem durante estações quentes e úmidas
- populações de militares destacados
- falta de cautela na seleção de alimentos e água
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- coprocultura e sensibilidade
- diagnóstico molecular de vários patógenos (reação em cadeia da polimerase)
- antígenos de fezes para protozoários
Investigações a serem consideradas
- exame de ovos e parasitas nas fezes
- Toxina do Clostridioides difficile nas fezes
- colonoscopia, endoscopia e biópsia
- hematologia, química sanguínea, sorologia
Algoritmo de tratamento
profilaxia antes da viagem
adultos não gestantes: diarreia leve
adultas não gestantes: diarreia moderada
adultos não gestantes: diarreia grave
gestante
crianças
Colaboradores
Autores
Daniel T. Leung, MD, MSc
Associate Professor
Division of Infectious Diseases
University of Utah School of Medicine
Salt Lake City
UT
Declarações
DTL receives authorship royalties from UpToDate, Inc, for a chapter on travel medicine. DTL is an author of upcoming chapters on traveller's diarrhoea 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
Declarações
JP declares that he has no competing interests.
Agradecimentos
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.
Declarações
MR has given talks on the management of traveller's diarrhoea 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 traveller'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 programme. While this is not in conflict with traveller’s diarrhoea, Pfizer also makes azithromycin, which is an antibiotic recommended for the treatment of traveller’s diarrhoea. 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
Andrea Summer, MD
Assistant Professor of Pediatrics
Medical University of South Carolina
Charleston
SC
Declarações
AS declares that she has no competing interests.
Phil Fischer, MD
Professor of Pediatrics
Department of Pediatric and Adolescent Medicine
Mayo Clinic
Rochester
MN
Declarações
PF is an author of a reference cited in this topic.
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