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CholeraCholera
Dr. Rachel Joshua ThundyilDr. Rachel Joshua Thundyil
AgentAgent
• Gram Negative Bacilli
• Vibrio Cholerae
• Curved, Actively Motile, Flagellated
• Narural Host - Humans
• Transmission – Faeco-oral route
Water
Food
Carriers
Clinical FeaturesClinical Features
• Incubation Period - few hours to 6 days
• 3 Phases - Evacuation Phase
- Collapse Phase
- Recovery Phase
Evacuation PhaseEvacuation Phase
• Abrupt onset
• Painless
• Watery diarrhoea “rice-water” without vomitting
Collapse PhaseCollapse Phase
• Shock – Cold, clammy skin
Tachycardia
Hypotension
CyanosisDehydration – Sunken eyes
Hollow Cheek
Decreased urine output
Recovery PhaseRecovery Phase
• Patient gradually recovers
ComplicaitonsComplicaitons
• Shock
• Convulsions
• Renal Failure
• Aspiration Pneumonia
DiagnosisDiagnosis
• Clinical
• Rectal swab for C & S
TreatmentTreatment
• Rehydration
• Antibiotics
RehydrationRehydration
• Mild dehydration
• Moderate dehydration
• Severe dehydration
Mild DehydrationMild Dehydration
• Use ORS
• 50 ml/kg in the first 4 hours
• 100 ml/kg till diarrhoea stops
Moderate DehydrationModerate Dehydration
• Use ORS
• 100 ml/kg in the first 4 hours
• 10 – 15 ml/kg/hour
Severe DehydrationSevere Dehydration
• Use IV Fluids
• Ringer – Lactate, followed by ORS
AntibioticsAntibiotics
• Doxycyclin 100 mg stat – for adults
• EES for 5 days for children
Thank youThank you
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