Cholera natural history, complications, and prognosis
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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 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 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.