Cholera natural history, complications, and prognosis: Difference between revisions
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{{Cholera}} | {{Cholera}} | ||
{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com] | {{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com], {{SaraM}} | ||
==Overview== | ==Overview== | ||
Cholera | Cholera infection can cause a severe diarrheal disease with acute and substantial loss of water and [[electrolytes]].<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = 376–7 |publisher = McGraw Hill | year = 2004 | isbn = 0838585299 }}</ref> The [[incubation period]] is very short (2 hours to 5 days), which allows the number of cases in an area to rise extremely quickly. Delayed initiation of [[oral rehydration therapy]] or inadequate rehydration may lead to [[hypotension]] and [[electrolyte imbalance]] (mostly [[hypokalemia]]). If [[dehydration]] is left untreated, it may lead to [[hypotension]], which can result in [[renal failure]], [[hypovolemic shock]], [[coma]], and death. If [[hypokalemia]] is left untreated, it can lead to [[nephropathy]] and [[myocardial necrosis|focal myocardial necrosis]]. Among the children, [[hypoglycemia]] is common and can lead to [[seizures]].<ref name=Cholera-outbreak> World Health Organization. Assessing the Outbreak response and improving preparedness (2004) http://apps.who.int/iris/bitstream/10665/43017/1/WHO_CDS_CPE_ZFk_2004.4_eng.pdf</ref> | ||
If patients with [[cholera]] are treated quickly and properly, the [[mortality rate]] is less than 1%. However, when [[cholera]] is left untreated, the [[mortality rate]] rises to 50–60%.<ref name=Lancet2004>{{cite journal |author=Sack DA, Sack RB, Nair GB, Siddique AK |title=Cholera |journal=Lancet |volume=363 |issue=9404 |pages=223–33 |year=2004 |month=January |pmid=14738797 |doi= 10.1016/S0140-6736(03)15328-7|url=}}</ref><ref>{{cite web|first=Kenneth |last=Todar |url=http://www.textbookofbacteriology.net/cholera.html |title=''Vibrio cholerae'' and Asiatic Cholera |publisher=Todar's Online Textbook of Bacteriology |date= |accessdate=2010-12-20}}</ref> | |||
==Complications== | ==Natural history, complications, and prognosis== | ||
===Natural history=== | |||
Cholera infection can cause a severe [[diarrheal]] disease with acute and substantial loss of water and [[electrolytes]].<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = 376–7 |publisher = McGraw Hill | year = 2004 | isbn = 0838585299 }}</ref> The [[incubation period]] is very short (2 hours to 5 days), which allows the number of cases in an area to rise extremely quickly. Delayed initiation of [[oral rehydration therapy]] or inadequate rehydration may lead to [[hypotension]] and [[electrolyte imbalance]] (mostly [[hypokalemia]]). If [[dehydration]] is left untreated, it may lead to [[hypotension]], which can result in [[renal failure]], [[hypovolemic shock]], [[coma]], and death. If [[hypokalemia]] is left untreated, it can lead to [[nephropathy]] and [[myocardial necrosis|focal myocardial necrosis]]. Among the children, [[hypoglycemia]] is common and can lead to [[seizures]].<ref name=Cholera-outbreak> World Health Organization. Assessing the Outbreak response and improving preparedness (2004) http://apps.who.int/iris/bitstream/10665/43017/1/WHO_CDS_CPE_ZFk_2004.4_eng.pdf</ref> | |||
If patients with [[cholera]] are treated quickly and properly, the [[mortality rate]] is less than 1%. However, when [[cholera]] is left untreated, the [[mortality rate]] rises to 50–60%.<ref name=Lancet2004>{{cite journal |author=Sack DA, Sack RB, Nair GB, Siddique AK |title=Cholera |journal=Lancet |volume=363 |issue=9404 |pages=223–33 |year=2004 |month=January |pmid=14738797 |doi= 10.1016/S0140-6736(03)15328-7|url=}}</ref><ref>{{cite web|first=Kenneth |last=Todar |url=http://www.textbookofbacteriology.net/cholera.html |title=''Vibrio cholerae'' and Asiatic Cholera |publisher=Todar's Online Textbook of Bacteriology |date= |accessdate=2010-12-20}}</ref> | |||
===Complications=== | |||
Major complications of [[cholera]] include:<ref name=Chol-comp>Cieza J, Sovero Y, Estremadoyro L, et al: Electrolyte disturbances in elderly patients with severe diarrhea due to cholera. J Am Soc Nephrol 1995; 6: pp. 1463</ref><ref name=Cholera-outbreak> World Health Organization. Assessing the Outbreak response and improving preparedness (2004) http://apps.who.int/iris/bitstream/10665/43017/1/WHO_CDS_CPE_ZFk_2004.4_eng.pdf</ref> | |||
* [[Hypotension]] | * [[Hypotension]] | ||
* [[ | * [[Hypovolemic shock]] | ||
* [[Coma]] | * [[Coma]] | ||
* Electrolyte imbalance | * [[Renal failure]] | ||
* [[ | * [[Electrolyte imbalance]] | ||
**[[Hypokalemia]] | |||
**[[Hyponatremia]] | |||
**[[Hypocalcemia]] (occasionally) | |||
* [[Metabolic acidosis]] | |||
* Death | |||
==Prognosis== | ===Prognosis=== | ||
If people with cholera are treated quickly and | If people with [[cholera]] are treated quickly and adequately, the [[mortality rate]] is less than 1%. However, if [[cholera]] is left untreated, the [[mortality rate]] rises to 50–60%.<ref name=Lancet2004>{{cite journal |author=Sack DA, Sack RB, Nair GB, Siddique AK |title=Cholera |journal=Lancet |volume=363 |issue=9404 |pages=223–33 |year=2004 |month=January |pmid=14738797 |doi= 10.1016/S0140-6736(03)15328-7|url=}}</ref><ref>{{cite web|first=Kenneth |last=Todar |url=http://www.textbookofbacteriology.net/cholera.html |title=''Vibrio cholerae'' and Asiatic Cholera |publisher=Todar's Online Textbook of Bacteriology |date= |accessdate=2010-12-20}}</ref> | ||
== References == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2], Sara Mehrsefat, M.D. [3]
Overview
Cholera infection can cause a severe diarrheal disease with acute and substantial loss of water and electrolytes.[1] The incubation period is very short (2 hours to 5 days), which allows the number of cases in an area to rise extremely quickly. Delayed initiation of oral rehydration therapy or inadequate rehydration may lead to hypotension and electrolyte imbalance (mostly hypokalemia). If dehydration is left untreated, it may lead to hypotension, which can result in renal failure, hypovolemic shock, coma, and death. If hypokalemia is left untreated, it can lead to nephropathy and focal myocardial necrosis. Among the children, hypoglycemia is common and can lead to seizures.[2] If patients with cholera are treated quickly and properly, the mortality rate is less than 1%. However, when cholera is left untreated, the mortality rate rises to 50–60%.[3][4]
Natural history, complications, and prognosis
Natural history
Cholera infection can cause a severe diarrheal disease with acute and substantial loss of water and electrolytes.[1] The incubation period is very short (2 hours to 5 days), which allows the number of cases in an area to rise extremely quickly. Delayed initiation of oral rehydration therapy or inadequate rehydration may lead to hypotension and electrolyte imbalance (mostly hypokalemia). If dehydration is left untreated, it may lead to hypotension, which can result in renal failure, hypovolemic shock, coma, and death. If hypokalemia is left untreated, it can lead to nephropathy and focal myocardial necrosis. Among the children, hypoglycemia is common and can lead to seizures.[2] If patients with cholera are treated quickly and properly, the mortality rate is less than 1%. However, when cholera is left untreated, the mortality rate rises to 50–60%.[3][5]
Complications
Major complications of cholera include:[6][2]
- Hypotension
- Hypovolemic shock
- Coma
- Renal failure
- Electrolyte imbalance
- Hypokalemia
- Hyponatremia
- Hypocalcemia (occasionally)
- Metabolic acidosis
- Death
Prognosis
If people with cholera are treated quickly and adequately, the mortality rate is less than 1%. However, if cholera is left untreated, the mortality rate rises to 50–60%.[3][7]
References
- ↑ 1.0 1.1 Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 376&ndash, 7. ISBN 0838585299.
- ↑ 2.0 2.1 2.2 World Health Organization. Assessing the Outbreak response and improving preparedness (2004) http://apps.who.int/iris/bitstream/10665/43017/1/WHO_CDS_CPE_ZFk_2004.4_eng.pdf
- ↑ 3.0 3.1 3.2 Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. doi:10.1016/S0140-6736(03)15328-7. PMID 14738797. Unknown parameter
|month=ignored (help) - ↑ Todar, Kenneth. "Vibrio cholerae and Asiatic Cholera". Todar's Online Textbook of Bacteriology. Retrieved 2010-12-20.
- ↑ Todar, Kenneth. "Vibrio cholerae and Asiatic Cholera". Todar's Online Textbook of Bacteriology. Retrieved 2010-12-20.
- ↑ Cieza J, Sovero Y, Estremadoyro L, et al: Electrolyte disturbances in elderly patients with severe diarrhea due to cholera. J Am Soc Nephrol 1995; 6: pp. 1463
- ↑ Todar, Kenneth. "Vibrio cholerae and Asiatic Cholera". Todar's Online Textbook of Bacteriology. Retrieved 2010-12-20.