Diarrhea in the returned traveller

Microbiology

• Bacteria
  • Escherichia coli (entero-hemorragic (EHEC), entero-toxigenic (ETEC)): most common cause
    • Usually afebrile
    • Diffusely adherent E. coli (DAEC) also exists
  • Campylobacter jejuni: more common in SE Asia
  • Salmonella species (non-typhoidal)
  • Shigella species
  • Plesiomonas species (unclear if cause of diarrhea)
  • Vibrio cholerae
  • Aeromonas species
• Viruses
  • Norovirus: most common virus
  • Rotavirus
• Parasites
  • Giardia lamblia: usually afebrile
  • Entamoeba histolytica
  • Cyclospora cayetanensis
  • Cryptosporidium
  • Strongyloides stercoralis