Diarreia do viajante
Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presença de fatores de risco
- diarreia (com ou sem tenesmo), cólicas, náuseas e vômitos
- disenteria (sangue e febre)
- diarreia persistente por >14 dias
Otros factores de diagnóstico
- diarreia sem doença
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- coprocultura e sensibilidade
- diagnóstico molecular de vários patógenos (reação em cadeia da polimerase)
- antígenos de fezes para protozoários
Pruebas diagnósticas que deben considerarse
- exame de ovos e parasitas nas fezes
- Toxina do Clostridioides difficile nas fezes
- colonoscopia, endoscopia e biópsia
- hematologia, química sanguínea, sorologia
Algoritmo de tratamiento
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
Divulgaciones
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
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 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 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
- Intoxicação alimentar
- Síndrome do intestino irritável
- deficiência secundária de dissacaridase (ou outra deficiência alimentar)
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
Diarreia em adultos
Más Folletos para el paciente
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