-IBIS-1.5.0-
tx
digestive system
cholera
diagnoses

definition and etiology

definition:
an acute bacterial infection of the small intestine characterized by sudden onset, profuse watery diarrhea, vomiting, rapid dehydration, muscular cramps, oliguria and circulatory collapse

etiology:
The associated microorganism is Vibrio cholerae. The patient sensitivity varies, and a leading factor is that Vibrio cholerae is very sensitive to gastric acid. Therefore, people with hypo- or achlorhydria are more susceptible to infection. Cholera is spread by the fecal-oral route and is endemic in areas of Asia, Africa and the Middle East. It commonly causes an asymptomatic or mild disease, especially in children. Morbidity results from extensive loss of potassium, sodium, chloride, and bicarbonate through the stools.

signs and symptoms

signs and symptoms: incubation is from a few hours to 5 days; 2-3 days is the average, then the onset is quite abrupt
• watery, painless diarrhea
• vomiting: may follow or precede the diarrhea and is not associated with nausea
• severe thirst
• muscle cramps: often of the calves
• oliguria becoming anuria with severe disease
• weakness, loss of tissue turgor, sunken eyes
• severe cases: cyanosis, stupor, collapse, acute renal failure

lab findings:
• Vibrio cholerae in stool culture
• rise in titer of antitoxic or vibriocidal antibodies
• visualization of the V. cholerae with darkfield examination
• hypovolemia and hemoconcentration
• marked metabolic acidosis

course and prognosis

Typically, the disease resolves within 2-7 days. Untreated, severe cases may be fatal within hours (50% fatality rate in serious cases); with electrolyte maintenance and fluid replacement, mortality drops to 1%. Most patients are free of V. cholerae within two weeks, but a few go on to become carriers of the organism, which may reside in the gallbladder.

differential diagnosis

• other microorganisms causing acute enteritis


footnotes