Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Updated: Apr 13 2020

Vibrio cholerae

5.0

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(4)

Images
https://upload.medbullets.com/topic/104063/images/v_cholerae.jpg
https://upload.medbullets.com/topic/104063/images/cholera_rehydration_nurses.jpg
  • Snapshot
    • A 40-year-old man presents to a local emergency room. He is currently on a medical mission in India. He reports sudden-onset nausea, vomiting, and copious amounts of watery diarrhea. His blood pressure is 93/65 mmHg and pulse is 114/min. On physical exam, he has sunken eyes, decreased skin turgor, and dry mucous membranes. He is given intravenous rehydration with the goal of rapid rehydration.
  • Introduction
    • Classification
      • Vibrio cholerae
        • a comma-shaped, flagellated, and gram(-) rod
        • oxidase + and produces cholera toxin
      • transmission
        • fecal-oral via water or uncooked food
    • Epidemiology
      • incidence
        • rare in the United States
      • demographics
        • endemic in developing countries
        • most severe in children
      • risk factors
        • raw seafood
        • contaminated water
        • travel
    • Pathogenesis
      • acid-labile enterotoxin activates Gs and overactivates adenylate cyclase, causing ↑ cAMP
        • requires large inoculum or decreased acidity in the host’s stomach
        • causes ↑ chloride secretion, resulting in secretory diarrhea and water efflux
        • this results in loss of potassium and bicarbonate
    • Prevention
      • live-attenuated oral cholera vaccine
        • indication
          • adults traveling to endemic areas
          • > 10 days prior to travel
    • Prognosis
      • if untreated, mortality is > 50%
      • if treated, mortality is < 1%
  • Presentation
    • Symptoms
      • may be asymptomatic
      • acute onset
        • painless rice-water secretory diarrhea
        • nausea
        • vomiting
    • Physical exam
      • dehydration
        • sunken eyes
        • dry mucous membranes
        • decreased skin turgor
  • Studies
    • Labs
      • stool culture in alkaline media
        • definitive diagnosis but not always necessary
        • no white blood cells in stool
      • electrolyte abnormalities
        • hypokalemia
        • hyponatremia
        • metabolic acidosis
    • Making the diagnosis
      • most cases are clinically diagnosed
  • Differential
    • Norovirus diarrhea
      • distinguishing factors
        • often associated with cruise ships, child care centers, or other crowded condition
        • typically self-limited
        • no association with geographic endemic locations
    • Campylobacter jejuni-associated diarrhea
      • distinguishing factors
        • bloody diarrhea
        • comma-shaped, but does not grow in alkaline media
        • white blood cells in stool
  • Treatment
    • Management approach
      • management is centered around rapid rehydration
    • Conservative
      • oral rehydration
        • indication
          • all patients
      • intravenous hydration
        • indication
          • severe dehyration
    • Medical
      • antibiotics
        • indication
          • severe dehydration
        • drugs
          • doxycycline
          • tetracycline
          • ciprofloxacin
  • Complications
    • Rapid dehydration
    • Hypovolemic shock
    • Death
Card
1 of 0
Question
1 of 3
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options