Infectious diseases. Cholera. Clinic. Diagnostics. Complications (most important)

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Infectious diseases. Cholera. Clinic. Diagnostics. Complications (most important)

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7. Cholera. Clinic. Diagnostics. Complications

Clinical manifestations. The incubation period lasts from 6 hours to 5 days, in vaccinated - up to 9-10 days. Clinical manifestations largely depend on the age of the child. Cholera usually begins acutely: copious watery stools suddenly appear, in the most severe cases they become more frequent, very copious, they pass freely, and they look like rice water and acquire an unusual smell. In less severe cases, the stools are yellowish in color. Vomiting is characteristic only for severe forms of infection, it usually develops after the onset of diarrhea. Sharp weakness and adynamia is one of the most characteristic and early signs of cholera.

Massive fluid loss can be accompanied by a decrease in body weight by 10% or more, which leads to deep dehydration and vascular collapse. In the most severe cases, blood pressure decreases, the pulse on the radial artery is not detected, breathing becomes deep and quickens, urine output stops. The eyes and fontanelles sink, the skin is cold, sticky, its turgor is reduced, it gathers in folds on the fingers. Cyanosis is observed, painful contractions of the muscles of the extremities, especially the calves, appear. Patients are restless, experience extreme thirst. Lethargy may develop, the voice becomes low and quiet.

Diarrhea continues for 7 days. Subsequent manifestations of the disease depend on the adequacy of the therapy. The earliest sign of recovery is the normalization of the color of the stool, after which the diarrhea quickly stops.

Diagnosis. Cholera is diagnosed on the basis of the characteristic clinical picture of the disease, the epidemiological situation and the results of laboratory tests using:

1) bacteriological method, which is of decisive importance and includes microscopy of preparations from the studied biomaterial (feces, vomit, etc.) and its inoculation on a nutrient accumulation medium;

2) express methods of approximate value: luminescent-serological, microagglutination reaction, Polev-Yermolyeva method;

3) serological methods aimed at the detection of specific antibodies in the blood, using the agglutination reaction, the detection reaction of vibriocidal antibodies, the luminescent-serological method and the phage adsorption reaction.

Complications. In children, complications after suffering cholera are more common and more severe than in adults. Inadequate replacement of potassium losses can lead to hypokalemia, nephropathy, cardiac arrhythmias, and paralytic ileus. Too rapid transfusion of large amounts of fluid without correction of acidosis can lead to pulmonary edema. Before or during treatment, 10% of young children may develop coma, convulsions, or prolonged lethargy.

Author: Pavlova N.V.

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