Cholera medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

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]

Medical therapy

Summary of the treatment

  • Rehydrate with ORS or IV solution depending on the severity. Rehydration involves replenishment of the lost fluids and then maintenance of the fluid balance
  • Maintain hydration and monitor frequently the hydration status
  • Give antibiotics for severe cholera cases

Assessment of dehydration

Assessment of dehydration
Mental status Eyes Thirst Skin pinch Conclusions
Normal, Alert Normal, hydrated Normal Goes down quickly (spontaneously) No / Mild dehydration
Irritable Sunken Drink eagerly Goes back slowly (< 2 sec) Some / Moderate dehydration (in case if 2 of the symptoms are present)
Severe Sunken Drinks poorly Goes back slowly (> 2 sec) Severe dehydration (in case if 2 of the symptoms are present)




HOW TO PREPARE HOME-MADE ORS SOLUTION?

  • If ORS sachets are available: dilute one sachet in one litre of safe water
  • Otherwise: Add to one litre of safe water:
    • Salt 1/2 small spoon (2.5 grams)
    • Sugar 6 small spoons (30 grams)
  • Try to compensate for loss of potassium (for example, eat bananas or drink green coconut water)

References

  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]

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