Cholera history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]

Overview

Patient may give a history of consumption of contaminated food or water, and travel to an endemic area. The symptoms usually develop within 24-48 hour of consumption of contaminated food. Patient presents with sudden onset, painless, odorless, rice watery large volume stool, abdominal cramps, vomiting and fever. If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low blood pressure), wrinkled hands (poor skin turgor) , sunken eyes, mucle cramps (decreased potassium), and decreased urine output.

History and symptoms

History

File:PHIL 1939 lores.jpg

A person with severe dehydration due to cholera - note the sunken eyes and decreased skin turgor which produces wrinkled hands.

• Patient may give a history of consumption of contaminated food or water.
• Symptoms usually develop 24-48 hours of consumption.
• Recent travel to a cholera endemic area may be present.

Symptoms

Diarrhea

• Sudden onset
• Painless
• Odorless
• Watery consistency (initially it may have some fecal matter but with disease progression it is mostly watery)
• It is pale white in color and thus sometimes referred as 'Rice water stool'(this is so because it has similar color and consistency as water left after washing rice)
• Voluminous (stool volume during cholera is more than that of any other infectious diarrhea causing uncontrolled bowel movements). An untreated person with cholera may produce 10–20 litres of diarrhea a day with fatal results.
• Abdominal cramp (due to large volume of intestinal secretion)
• For every symptomatic person, three to 100 people get the infection but remain asymptomatic.

Vomiting

• Causes for vomiting are decreased intestinal motility and acidemia

Muscle cramp

• If the severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include dizziness ( due to low blood pressure), wrinkled hands (poor skin turgor) , sunken eyes, mucle cramps (decreased potassium), and decreased urine output.
• Cholera has been nicknamed the blue death due to a patient's skin turning a bluish-gray hue from extreme loss of fluids.

Fever

• Fever is usually absent.

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