Diarrhea in the returned traveller

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Differential Diagnosis

  • 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 (non-typhoidal)
    • Shigella
    • Plesiomonas (unclear if cause of diarrhea)
    • Vibrio cholerae
  • Viruses
    • Noroviruses: most common virus
  • Parasites
    • Giardia lamblia: usually afebrile
    • Entamoeba histolytica
    • Cyclospora cayetanensis
    • Cryptosporidium
    • Strongyloides stercoralis