(Tourista)

Under a traveler’s diarrhea is meant a gastroenteritis, which is generally caused by endemic in the local drinking water bacteria. Symptoms include vomiting and diarrhea. The diagnosis is made clinically essentially. The treatment consists of ciprofloxacin or azithromycin, loperamide and fluid replacement.

(See also Center for Disease Control and Prevention’s health information for travelers’ diarrhea.)

Under a traveler’s diarrhea is meant a gastroenteritis, which is generally caused by endemic in the local drinking water bacteria. Symptoms include vomiting and diarrhea. The diagnosis is made clinically essentially. The treatment consists of ciprofloxacin or azithromycin, loperamide and fluid replacement. (See also Center for Disease Control and Prevention’s health information for travelers’ diarrhea.) Etiology The traveler’s diarrhea is caused by a variety of bacteria, viruses or, less commonly, parasites. Enterotoxigenic Escherichia coli are the most common pathogens. E. coli is most commonly found in water supplies in regions where no adequate water treatment takes place. They often occur in people who travel to developing countries, on. Norovirus infection is a particular problem on some cruise ships. Both the food and the water can be the source of infection. Travelers who shun local drinking water, can be infected yet, z. For example, by brushing with insufficiently flushed toothbrushes, consumption of bottled beverages with ice from the local drinking water or consumption of food that has been improperly prepared or washed with local drinking water. For individuals taking medications that reduce stomach acid (antacids, H2 blockers and proton pump inhibitors), there is a risk of serious illness. Symptoms and discomfort nausea, vomiting, abnormal bowel sounds (Borborygmi), abdominal cramps and diarrhea beginning 12 to 72 hours after ingestion of contaminated food or water. vary the severity of the symptoms. Some people develop fever and myalgias. However, most cases are mild and self-limiting, although v. a. may occur in the warm air dehydration. Diagnosis Clinical evaluation specific diagnostic procedures are not required essentially. Fever, severe abdominal pain and bloody diarrhea indicate a severe disease and require immediate investigation. Therapy fluid replacement Occasionally motilitätshemmende drugs antibiotics (eg. As ciprofloxacin, azithromycin) in moderate to severe diarrhea mainstay of treatment is the replacement of a liquid and initial motilitätshemmendes drugs such as loperamide 4 mg p.o., followed by 2 mg p.o. (A maximum of 6 doses / day or 16 mg / day) or diphenoxylate 2.5-5 mg p.o. for each successive episode of diarrhea 3 times daily, or four times daily in tablet or liquid form. Children receive loperamide. The dose for children of 13-20 kg is 1 mg po 3 times a day, for children from 20 to 30 kg 2 mg po 2 times a day and for children> 30 kg to 12 years, 2 mg po 3 times a day. Adults and children ? 12 years of age can 4 mg p.o. after the first soft stool and then received 2 mg after each subsequent soft stool, wherein 16 mg should not be exceeded in a 24-hour period. Motilitätshemmende drugs are contraindicated in patients with fever or blood in the stool and in children <2 years. Jodochlorhydroxyquin, which is available in some developing countries, should not be used because it causes neurological damage. Generally, antibiotics are not necessary for mild diarrhea, however, (3 loose stools over 8 h ?) they are given to patients with moderate to severe diarrhea, v. a. If vomiting, abdominal pain, fever or bloody stools are made. For adults is ciprofloxacin 500 mg po 2 times daily for 3 days or levofloxacin 500 mg po once daily is recommended for 3 days. Azithromycin 250 mg p.o. once daily for 3 days or rifaximin 200 mg po 3 times daily for 3 days may also be used. In children Azithromycin is administered p.o. 5-10 mg / kg preferably once daily for 3 days. Prevention Travelers should eat in restaurants that are known for their safety and avoid food and drinks from street vendors. You should only boiled, nor take when eating hot food to be peelable fruits and carbonated drinks served without ice and bottles (bottles of non-carbonated beverages can tap water, which has been filled by unscrupulous sellers included). Uncooked vegetables (incl. One on the table left sauce) should be avoided. Buffets and fast-food restaurants also increase the risk. Prophylactic antibiotics are effective in preventing diarrhea, but should remain mainly reserved considering possible side effects and the development of resistance for immunkomprimittierte patients.

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