小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 腹泻（伴随或不伴随里急后重）痉挛、恶心和呕吐
- 痢疾（出血和发热）
- 持续腹泻 > 14天
其他诊断因素
- 无病症腹泻
危险因素
- 前往高风险目的地旅行
- 年龄＜30 岁
- 胃酸度降低
- 先前的 TD 敏感性
- 慢性病，免疫功能低下
- 之前因拜访亲友在发展中国家居住过的旅行者
- 在炎热和潮湿的季节旅行
诊断性检查
首要检查
- 粪便培养和药敏
- 粪便潜血
- 多病原菌分子诊断（聚合酶链反应）
- 粪便虫卵和寄生虫检查
需考虑的检查
- 原生动物粪便抗原检测
- 艰难梭菌粪便毒素检测
- 结肠镜检查、内窥镜检查和活检
- 血液学、血生化、血清学检测
治疗流程
旅行前预防
非妊娠成人：轻度腹泻
非妊娠成人：中度腹泻
非妊娠成人：重度腹泻
妊娠
儿童
撰稿人
作者
Mark Riddle, MD, MPH&TM, DrPH, C Trop Med, Certificate in Travel Health
Professor and Chair
Department of Preventive Medicine & Biostatistics
Uniformed Services University of the Health Sciences
Bethesda
MD
利益声明
MR has given talks on the management of traveller's diarrhoea for the International Society of Travel Medicine (ISTM), CDC Foundation, American College of Gastroenterology (ACG), and American College of Preventive Medicine. MR has led the development of guidelines for traveller's diarrhoea for the ISTM, ACG, and the US Department of Defense. This work has been unpaid but support for travel has been accepted. MR is an author of several references cited in this topic.
鸣谢
Dr Mark Riddle would like to gratefully acknowledge Professor Gregory Juckett, the previous contributor to this topic.
利益声明
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.
鉴别诊断
- 肠易激综合征
- 继发性双糖酶（或者其他饮食成分）缺乏症
- 吸收不良性疾病
更多 鉴别诊断指南
- 疾病预防控制中心黄皮书：旅行者腹泻
- 2017 年美国传染病学会 (Infectious Diseases Society of America) 感染性腹泻诊疗临床实践指南
更多 指南患者教育信息
Diarrhoea in adults
更多 患者教育信息
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