Causes of Acute Diarrhoea Following Recent Travel Abroad
| Cause | Clinical features | Diagnosis/treatment |
|---|---|---|
| Giardiasis(Giardia lamblia) | Widespread distribution. Explosive onset of watery diarrhoea 1–3 weeks after exposure. | Identification of cysts or trophozoites in stool or jejunal biopsy. Metronidazole 400 mg 8-hourly PO for 5 days. |
| Amoebic dysentery(Entamoeba histolytica) | Mexico, South America, South Asia, West and South-East Africa. Diarrhoea may be severe with blood and mucus. | Identification of cysts in stools. Metronidazole 750 mg 8-hourly PO for 5 days. |
| Schistosomiasis (S. mansoni and japonicum) | S. mansoni: South America and Middle East; S. japonicum: China and the Philippines. Diarrhoea onset 2–6 weeks or longer after exposure. | Identification of ova in stool. Praziquantel (seek expert advice). |
| Shigellosis (Shigella species) | Incubation period 1–2 days. Associated fever and abdominal pain. Diarrhoea may be watery or bloody. | Culture of Shigella species from stool. Ciprofloxacin 500 mg 12-hourly PO for 5 days or Trimethoprim 200 mg 12-hourly PO for 5 days. |
| Non-typhoid salmonellosis | See Community-acquired diarrhoea, Table 22.3. | |