question and answer
Single sample for traveller's diarrhea?
October 2004
BRIAN POELZER, MD, of Kamloops, BC, notes: "It's recommended that travellers returning with persisting transient gastroenteritis symptoms be tested for ova and parasites using only a single stool sample." He would like to know, "Is the timing important to improve the chances of finding something?"
Traveller's diarrhea in patients staying principally at resorts is usually a self-limited illness caused by enterotoxigenic Escherichia coli. Persisting symptoms are often due to non-infectious causes, such as transient lactose intolerance or dietary change. Parasitic infestation -- helminthic and amebic -- is much less common and a diligent search for such parasites isn't warranted in many individuals. A single sample will usually suffice. In people who are likely to have a parasitic infection, however -- i.e. prolonged stay in rural/endemic areas, consumption of contaminated foods/water, eosinophilia -- it's recommended that three separate stool specimens for microscopic examination be examined in order to maximize the chances of detection. KL
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