The returned traveller with diarrhoea.

BACKGROUND Traveller's diarrhoea is among the most frequently reported problems for travellers. Prevention remains a challenge in travellers and the appropriate management of traveller's diarrhoea remains paramount. OBJECTIVE This article provides an overview of the general approach to diarrhoea in the returned traveller, including identification of common causes and management. DISCUSSION The most common causes of traveller's diarrhoea are bacterial contamination of food and water, particularly with enterotoxigenic Escherichia coli. Most cases of traveller's diarrhoea are mild, are of short duration and do not require antibiotic treatment. Where the diarrhoea is severe, bloody and/or prolonged, then laboratory investigation is necessary. Where the patient is severely ill and possibly septicaemic, blood culture is mandatory. Presently, one of the most useful groups of the antibiotics routinely available for treatment is the fluoroquinolones.