Diarrhea in the returned traveler

Abstract

Diarrhea in the returned traveler is a common problem that can be caused by a number of different pathogens. A history of the patient's travel and exposures, the duration of illness, the response to prior treatment, and the clinical syndrome can help to establish a good etiologic differential diagnosis on which further therapy can be based. Many of these patients can be treated empirically with antibiotics, either a fluoroquinolone or azithromycin, without further microbiologic evaluation. Those patients with severe or persistent disease or comorbid illnesses, or those who have failed empiric therapy, should undergo further microbiologic evaluation with directed stool cultures and ova and parasite screening. For those patients with negative evaluations, further empiric therapy may be warranted if syndromes are suggestive of specific agents of infection, such as by Giardia or Cyclospora species. Other patients may require endoscopic evaluation to exclude diagnoses such as tropical sprue or inflammatory bowel disease.

Clinical Characteristics and Etiology of Travelers' Diarrhea among Korean Travelers Visiting South-East Asia

“…To our knowledge, ETEC is the most commonly found TD pathogen worldwide, while EAEC, Vibrio parahaemolyticus and Norovirus have been reported less frequently (4, 5, 11, 12). Some reports have described intestinal protozoa such as Giardia lamblia , Entamoeba histolytica , Cyclospora species and Cryptosporidium species as pathogens in 0%-17% of cases of TD (13-16). However, infection of protozoa was not included in this study.…”

Epidemiology, Etiology and Pathophysiology of Traveler’s Diarrhea

“…In recent years, C. cayetanensis has emerged as a causative organism of diarrhea [29] affecting travelers [30, 31]. Together with Cyclospora and Criptosporidium species, Giardia is often the cause of persistent diarrhea in the returned traveler [32]. …”

Beneficial Effects of Probiotic and Food Borne Yeasts on Human Health

“…Enterotoxigenic E. coli, Shigella and Salmonella account for about 80% of the cases with an identified pathogen [64]. In a meta-analysis study performed by McFarland [65], it has been concluded that S. cerevisiae var.…”