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cholera
Severe diarrhea caused by infection with Vibrio cholera.
Epidemiology:
- cholera outbreak in Yemen reaches 500,000 in August 2017 [4,5]
Pathology:
1) incubation period 1-5 days
2) enterotoxin stimulates secretion of Cl- from the small intestine
3) CXCL17 up-regulated in duodenal mucosa during acute cholera
Clinical manifestations:
1) sudden onset, severe diarrhea
2) abdominal cramps
3) vomiting
4) thirst
5) oliguria
6) hypotension
7) tachycardia
Laboratory:
1) watery mucoid stools
2) smear from stool contains Vibrio cholera organisms
3) stool culture
4) positive agglutinin tests
5) serum chemistries
a) diminished electrolytes
b) increased urea nitrogen
c) increased protein
6) complete blood count (CBC): leukocytosis
Management:
1) hydration with electrolyte replacement
2) disease is generally self-limited
3) antibiotic therapy can hasten resolution
a) tetracycline 2 g PO single dose*
b) doxycycline 300 mg PO single dose*
c) Bactrim 5 mg/kg (based on trimethoprim) PO BID for 3 days
d) ampicillin
e) fluoroquinolone
* adults & children > 8 years of age
Related
Vibrio cholerae
General
bacterial gastroenteritis
enterocolitis
Database Correlations
Kegg hsa/hsa05110
References
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 874
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY,
1994, pg 682
- World Health Organization (WHO). 24 June 2017
Statement from UNICEF Executive Director Anthony Lake and
WHO Director-General Margaret Chan on the cholera outbreak in
Yemen as suspected cases exceed 200,000.
http://www.who.int/mediacentre/news/statements/2017/Cholera-Yemen/en/
- World Health Organization (WHO). 24 June 2017
Cholera count reaches 500 000 in Yemen.
http://www.who.int/mediacentre/news/releases/2017/cholera-yemen-mark/en/