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Cholera

Frederick W. Nielson, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • An acute infectious disease caused by the gram-negative bacterium Vibrio cholerae

  • Characterized by severe diarrhea with extreme fluid and electrolyte depletion, vomiting, muscle cramp...

DIAGNOSIS

HISTORY

  • History of travel to endemic area and exposure to contaminated food/water source

  • Abrupt onset of explosive, painless watery diarrhea (“rice-water stools”) without tenesmus

  • Abdominal dis...

TREATMENT

  • Primary goal is to replenish fluid losses. With proper treatment, fatality rates are <1%.

  • Two phases of rehydration: initial and maintenance (4)[C]

    • Evaluate initial level of dehydration (cu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Bed rest until symptoms resolve and strength returns 

Patient Monitoring

Observe patient until symptoms are resolved. 

DIET

Small, frequent meals when vomiting stops ...

REFERENCES

1
Harris JB, LaRocque RC, Qadri F, et al. Cholera. Lancet.  2012;379(9835):2466–2476. {L-End} [View Abstract on OvidMedline]
2
Nickonchuk T, Lindblad AJ, Kolber MR. Oral cholera vaccine ...

ADDITIONAL READING

  • Ali M, Lopez AL, You YA, et al. The global burden of cholera. Bull World Health Organ.  2012;90(3):209A–218A.

  • Ali M, Nelson A, Luquero FJ, et al. Safety of a killed oral cholera...

SEE ALSO

Diarrhea, Acute; Oral Rehydration 

CODES

ICD10

  • A00.9 Cholera, unspecified

  • A00.0 Cholera due to Vibrio cholerae 01, biovar cholerae

  • A00.1 Cholera due to Vibrio cholerae 01, biovar eltor

ICD9

  • 001.9 Cholera, unspecified

  • 001.0 Cholera due to vib...

CLINICAL PEARLS

  • Personal (food and water selection/preparation; hand hygiene) and public sanitation are the keys to cholera prevention.

  • The current cholera vaccine is not indicated to prevent routine t...

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