[Traveller's diarrhea: epidemiology, clinical practice guideline for the prevention and treatment]

Bacterial causes are predominant: enterotoxigenic (ETEC) ou enteroadherent Escherichia coli, Salmonella sp., Shigella sp., Campylobacter jejuni, Acrobacter sp., enterotoxigenic Bacteroïdes fragilis. Prevention relies on the hand and food hygiene standards (heat-cooked meals). Watery diarrhea (toxigenic enterocolitis) is the most frequent clinical presentation associated with a risk of dehydration; the body temperature is normal except in cases of severe dehydration. Less frequent are invasive enterocolitis presenting as acute febrile diarrhea with dysentery (abdominal cramps, tenesmus, stools blended with mucus and blood): salmonellosis, shigellosis. Bacteremia may occur in immunocompromised patients. Early rehydration is essential with oral rehydration solutions (ORS) consisting of salt, sugar and water. Antibiotics should be reserved for invasive enterocolitis with fever and dysentery, profuse diarrhea with more than three liquid stools within 12 hours. Duration of antibiotherapy varies from 1 to 5 days.