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Pathology
Vibrio cholerae, motile curved gram negative rod. Secretory diarrhoea caused by toxin acting on enterocytes. Incubation period: few hours to 3 days.
Aetiology
Spread by faecal contamination of drinking water. .
Signs
Profound dehydration, electrolyte imbalance (reduced sodium, chloride and bicarbonate).
Symptoms
Abrupt painless watery ‘rice-water’ diarrhoea (up to 30 litres a day).
Investigations
Bloods: U&E (increased urea and creatinine in dehydration
ABG: Metabolic acidosis through loss of bicarbonate in stool.
Microbiology: Stool culture
Treatment
Accurate fluid balance, ORS, IVI fluids.
Prognosis
Excellent with treatment & support. ORS has reduced mortality of severe cholera from 50% down to 1%.
Circulatory collapse, arrhythmias, death.Key Facts
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Key References
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