title: Gastrointestinal symptoms in travellers.
abstract: Diarrhoea is probably the single most common medical complaint in returning travellers. The most common pathogens are entero-toxigenic Escherichia coli, Shigella, Salmonella and Campylobacter. Viruses, toxigenic Arcobacter and Bacteroides fragilis, as well as parasites such as Cryptosporidium sp, are increasingly recognised but are not tested for in most diagnostic laboratories. Blood in stools is a sign of invasive disease and should trigger exclusion of invasive amoebic disease. The use of empiric antibiotics may shorten illness but is complicated by the diversity of bacterial causes and emerging resistance.
authors: Hospital for Tropical Diseases, London, UK, and Imported Fever Service, Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, UK.
authors: Alastair C
authors: AC
authors: McGregor
authors: Hospital for Tropical Diseases, London, UK, and consultant physician, King Edward VII Hospital, London, UK stephenwright1@doctors.net.uk.
authors: Stephen G
authors: SG
authors: Wright
mesh_terms: D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D014195:Travel
keywords: Diarrhoea; gastroenteritis; imported; travel; travellers
references: Cochrane Database Syst Rev. 2000;(3):CD002242
references: 10908534
references: Clin Infect Dis. 2001 Feb 1;32(3):331-51
references: 11170940
references: J Clin Microbiol. 2003 Oct;41(10):4745-50
references: 14532214
references: Trans R Soc Trop Med Hyg. 2003 Jul-Aug;97(4):414-5
references: 15259470
references: Am J Gastroenterol. 2004 Sep;99(9):1774-8
references: 15330917
references: Clin Infect Dis. 2005 Dec 1;41 Suppl 8:S536-40
references: 16267715
references: Clin Microbiol Infect. 2006 Sep;12(9):921-4
references: 16882300
references: Parasite. 2008 Sep;15(3):261-5
references: 18814692
references: Clin Infect Dis. 2010 Jul 15;51(2):123-30
references: 20540620
references: J Clin Microbiol. 2010 Nov;48(11):4140-6
references: 20861334
references: Curr Opin Gastroenterol. 2012 Jan;28(1):24-9
references: 22080823
references: Trans R Soc Trop Med Hyg. 2012 Sep;106(9):549-53
references: 22818743
references: Travel Med Infect Dis. 2014 Jul-Aug;12(4):401-5
references: 24889052
references: Lancet. 1985 Mar 30;1(8431):719-21
references: 2857996