Weill Medical College of Cornell University, New York, NY, USA.
J Travel Med. 2013 Sep-Oct;20(5):303-12. doi: 10.1111/jtm.12049. Epub 2013 Jul 9.
Travelers' diarrhea (TD) has generally been considered a self-limited disorder which resolves more quickly with expeditious and appropriate antibiotic therapy given bacteria are the most frequently identified cause. However, epidemiological, clinical, and basic science evidence identifying a number of chronic health conditions related to these infections has recently emerged which challenges this current paradigm. These include serious and potentially disabling enteric and extra-intestinal long-term complications. Among these are rheumatologic, neurologic, gastrointestinal, renal, and endocrine disorders. This review aims to examine and summarize the current literature pertaining to three of these post-infectious disorders: reactive arthritis, Guillain-Barré syndrome, and post-infectious irritable bowel syndrome and the relationship of these conditions to diarrhea associated with travel as well as to diarrhea associated with gastroenteritis which may not be specifically travel related but relevant by shared microbial pathogens. It is hoped this review will allow clinicians who see travelers to be aware of these post-infectious sequelae thus adding to our body of knowledge in travel medicine.
Data for this article were identified by searches of PubMed and MEDLINE, and references from relevant articles using search terms "travelers' diarrhea" "reactive arthritis" "Guillain-Barré syndrome" "Post-Infectious Irritable Bowel Syndrome." Abstracts were included when related to previously published work.
A review of the published literature reveals that potential consequences of travelers' diarrhea may extend beyond the acute illness and these post-infectious complications may be more common than currently recognized. In addition since TD is such a common occurrence it would be helpful to be able to identify those who might be at greater risk of post-infectious sequelae in order to target more aggressive prophylactic or therapeutic approaches to such individuals. It is hoped this review will allow clinicians who see travelers to be aware of these post-infectious sequelae thus adding to our body of knowledge in travel medicine.
旅行者腹泻（TD）通常被认为是一种自限性疾病，如果能迅速给予适当的抗生素治疗，细菌是最常见的病因，病情会更快缓解。然而，最近出现了一些流行病学、临床和基础科学证据，表明与这些感染相关的许多慢性健康状况与之相悖，挑战了这一现有模式。这些健康状况包括严重且可能导致残疾的肠内和肠外长期并发症。其中包括风湿性疾病、神经疾病、胃肠道疾病、肾脏疾病和内分泌疾病。本综述旨在检查和总结与三种感染后疾病相关的现有文献：反应性关节炎、格林-巴利综合征和感染后肠易激综合征，以及这些疾病与旅行相关腹泻和与胃肠炎相关腹泻（可能与旅行无关，但与共同的微生物病原体有关）的关系。希望本综述能让诊治旅行者的临床医生意识到这些感染后的后果，从而丰富旅行医学领域的知识体系。
本文的数据通过在 PubMed 和 MEDLINE 上搜索，并使用“旅行者腹泻”“反应性关节炎”“格林-巴利综合征”“感染后肠易激综合征”等关键词搜索相关文章和参考文献获得。摘要中包含了与已发表研究相关的内容。
对已发表文献的综述表明，旅行者腹泻的潜在后果可能超出急性疾病的范围，这些感染后并发症可能比目前认识到的更为常见。此外，由于 TD 是如此常见的疾病，了解哪些人可能更容易发生感染后后遗症，以便针对这些人采取更积极的预防或治疗方法，将是非常有帮助的。希望本综述能让诊治旅行者的临床医生意识到这些感染后的后果，从而丰富旅行医学领域的知识体系。
