Travellers diarrohoea

Question 1

How many episodes of loose stools define travellers diarrhoea? Acute vs chronic

Answer 1

> 3/24hrs - diarrhoea
6/24hrs - severe

<2wks - acute
>2wks - persistent/chronic

Question 2

Common pathogens of travellers diarrohoe

Answer 2

mcc - ETEC
Salmonella, shigella
Campylobacter
Vibrios
Viral
Parasitic (entamoeba histolytica, giardia)

Russia -
Giardia
Cryptosporidium

Question 3

Cause of acute and chronic bloody diarrhoea

Answer 3

<2wks
ETEC - mcc
Campylobacter
Salmonella

> 2wks, bubly, smelly
Giardia

3months
Entamoeba histolytica

Question 4

Mx of mild diarrohoea

Answer 4

●1 episode in 24hrs
●Oral rehydration - 2glasses of water for every episode
●Hydrating solution - 2-3L/day (adult), 50ml/kg in 4 hrs (children)

Question 5

Mx of mod diarrhoea

Answer 5

●=>3episodes in 24hrs
+ nausea/vomit/mucous stools/abd cramps/bloody
●Norfloxacin + loperamide x3days
*Avoid loperamide in bloody stools
*Avoid iron, zinc, antacids with norflox
●Azithral 1000mg stat in floroquinolone resistence

*Norflox is not generally recommended for diarrhoea as its S/E is diarrhoea
*Fluoroquinolone MOA - Anti topoisomerase 2 and 4

Question 6

Mx of diarrhoea with no other symptoms

Answer 6

Buscopan/Loperamide

Question 7

Mx of bloody diarrhoea

Answer 7

Norflox x 3days
..
Still +
..
?Amoebic dysentery
Tinidazole 2gms x3days

or Metronidazole

Question 8

Mx of diarrhoea d/t Giardia

Answer 8

Mc in russia
Bubly, foul, floating stools
>7days, persistent

Tinidazole 2gms stat

or Metronidazole

Question 9

Mx of Campylobacter diarrhoea

Answer 9

Azithral 500mg x 3days - DOC
Erythromycin