title: Review of the causes and management of chronic gastrointestinal symptoms in returned travellers referred to an Australian infectious diseases service.
abstract: BACKGROUND
  Thirty to seventy per cent of overseas travellers experience traveller's diarrhoea (TD), a potential cause of serious gastrointestinal (GI) sequelae. However, there is limited evidence on the optimal management of TD.
  
  
  OBJECTIVE
  The objectives of this article are to characterise the aetiologies and management of returned travellers with ongoing GI symptoms referred to a specialist infectious diseases service.
  
  
  METHODS
  We conducted a retrospective medical record review of patients referred to the Victorian Infectious Disease Service (VIDS) in 2013-15 with a history of overseas travel and GI symptoms present for longer than two weeks. For each diagnostic group, we compared demographic and travel characteristics, illness course, investigation results, and number of and response to treatments.
  
  
  RESULTS
  The most common diagnosis was parasitic infection (31 out of 65 patients). Referral was made for infection with a controversial or uncommon organism; negative microbiological findings +/- failed metronidazole treatment; or severe or prolonged infections.
  
  
  CONCLUSIONS
  Our results highlight the utility of ordering more than one faecal specimen for oocytes, cysts and parasites (O/C/P) examination, potential benefits of tinidazole use, and role of specialist services for uncertain diagnoses and complex and/or unusual organ-isms.
authors.forename: Noha
authors.initials: N
authors.lastname: Ferrah
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.forename: Katherine
authors.initials: K
authors.lastname: Gibney
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001315:Australia; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology / Q000469:parasitology / Q000628:therapy; D005243:Feces / Q000469:parasitology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D055552:Infectious Disease Medicine / Q000706:statistics & numerical data; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D014195:Travel
chemical_list: D000890:Anti-Infective Agents