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==Physical examination==
==Physical examination==
The signs on physical examination depends on the level of dehydration and patient may present with tachycardia, postural hypotension, somnolence, dry mucous membrane, sunken eyes,oliguria. If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening [[dehydration]] and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low [[blood pressure]]), wrinkled hands (poor skin turgor) , sunken eyes, muscle cramps (decreased potassium), and decreased urine output.
The signs on physical examination depends on the level of dehydration and patient may present with tachycardia, postural hypotension, somnolence, dry mucous membrane, sunken eyes,oliguria. If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening [[dehydration]] and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low [[blood pressure]]), wrinkled hands (poor skin turgor) , sunken eyes, muscle cramps (decreased potassium), and decreased urine output.
==Lab tests==
Lab tests are not mandatory for diagnosis and treatment of cholera. In endemic areas when suspected, treatment should be started as early as possible with fluid replacement and antibiotics. In areas where cholera is uncommon, performing lab tests are worthwhile.Tests used for identification of organisms are: Direct microscopic examination of organism, dark field examination, gram staining, culture, antigen, polymerase chain reaction and serotype tests


== References ==
== References ==

Revision as of 18:52, 3 April 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Overview

Choleria is a severe bacterial gastrointestinal, diarrheal disease. In its most severe forms, cholera is one of the most rapidly fatal illnesses known. A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided. More commonly, the disease progresses from the first liquid stool to shock in 4-12 hours, with death following in 18 hours to several days without rehydration treatment.[1][2]

Background

Cholera (or Asiatic cholera or epidemic cholera) is a severe diarrheal disease caused by the bacterium Vibrio cholerae.[3] Transmission to humans is by ingesting contaminated water or food. The major reservoir for cholera was long assumed to be humans, but some evidence suggests that it is the aquatic environment.

V. cholerae is a Gram-negative bacteria which produces cholera toxin, an enterotoxin, whose action on the mucosal epithelium lining of the small intestine is responsible for the characteristic massive diarrhea of the disease.[3] In its most severe forms, cholera is one of the most rapidly fatal illnesses known. A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided.[3] More commonly, the disease progresses from the first liquid stool to shock in 4-12 hours, with death following in 18 hours to several days without rehydration treatment.[1][4]

Cholera is an infection of the small intestine caused by the bacterium Vibrio cholerae. The main symptoms are profuse, watery diarrhea and vomiting. Transmission occurs primarily by drinking water or eating food that has been contaminated by the feces of an infected person, including one with no apparent symptoms. The severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte imbalance, and death in some cases. The primary treatment is oral rehydration therapy, typically with oral rehydration solution (ORS), to replace water and electrolytes. If this is not tolerated or does not provide improvement fast enough, intravenous fluids can also be used. Antibacterial drugs are beneficial in those with severe disease to shorten its duration and severity. Worldwide, it affects 3–5 million people and causes 100,000–130,000 deaths a year as of 2010. Cholera was one of the earliest infections to be studied by epidemiological methods.

History and symptoms

Patient may give a history of consumption of contaminated food or water, and travel to an endemic area. The symptoms usually develop within 24-48 hour of consumption of contaminated food. Patient presents with sudden onset, painless, odorless, rice watery large volume stool, abdominal cramps, vomiting and fever. If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low blood pressure), wrinkled hands (poor skin turgor) , sunken eyes, mucle cramps (decreased potassium), and decreased urine output.

Physical examination

The signs on physical examination depends on the level of dehydration and patient may present with tachycardia, postural hypotension, somnolence, dry mucous membrane, sunken eyes,oliguria. If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low blood pressure), wrinkled hands (poor skin turgor) , sunken eyes, muscle cramps (decreased potassium), and decreased urine output.

Lab tests

Lab tests are not mandatory for diagnosis and treatment of cholera. In endemic areas when suspected, treatment should be started as early as possible with fluid replacement and antibiotics. In areas where cholera is uncommon, performing lab tests are worthwhile.Tests used for identification of organisms are: Direct microscopic examination of organism, dark field examination, gram staining, culture, antigen, polymerase chain reaction and serotype tests

References

  1. 1.0 1.1 McLeod K (2000). "Our sense of Snow: John Snow in medical geography". Soc Sci Med. 50 (7–8): 923–35. PMID 10714917.
  2. WHO Cholera [1]
  3. 3.0 3.1 3.2 Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 376&ndash, 7. ISBN 0838585299.
  4. WHO Cholera [2]

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