[Travelers' diarrhea].

More than 12 million international travellers contract diarrhea every year. Today more than 80% of the pathogenic agents can be found: virus (Rotavirus and virus of Norwalk), bacteria or parasites. Most of the aqueous diarrheas are due to E. coli secreting an enterotoxin which acts like the toxin of V. cholerae in stimulating adenylcyclase in the epithelial cells of the small intestine. This enterotoxin is bound to a plasmid and may be transferred to other enterobacteriaceae. In contrast, in the dysenteric form of diarrhea the bacteria penetrate into the mucosa and elicit inflammation and ulcers. The author's usual complementary examinations include methylene-blue coloration of the stool and testing for occult blood. Most traveller's diarrheas subside spontaneously. Treatment with a compound of clioquinol is more hazardous than useful. The antimotility agents are derivatives of opium and should not be given to patients with fever or the dysenteric form of diarrhea. Prophylaxis with a second generation tetracycline or the combination of sulfamethoxazole-trimethoprim may be justified.