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Traveler's diarrhea

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 20 Aug 2025
Última atualização: 03 Sep 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

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

Outros fatores diagnósticos

  • diarrhea without illness
Detalhes completos

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • stool culture and sensitivity
  • multipathogen molecular diagnostic (polymerase chain reaction)
  • protozoal stool antigens
Detalhes completos

Investigações a serem consideradas

  • stool ova and parasite exam
  • Clostridioides difficile stool toxin
  • colonoscopy, endoscopy, and biopsy
  • hematology, blood chemistries, serology
Detalhes completos

Algoritmo de tratamento

Inicial

pretravel prophylaxis

pre-travel prophylaxis

AGUDA

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

Declarações

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

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 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

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.

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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  Resumo

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  Resumo

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. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

  • Diagnósticos diferenciais

    • Food poisoning
    • Irritable bowel syndrome
    • Secondary disaccharidase (or other dietary) deficiency
    Mais Diagnósticos diferenciais

  • Diretrizes

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

  • Folhetos informativos para os pacientes

    Diarrhea in adults

    Mais Folhetos informativos para os pacientes
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