The diagnosis and treatment of cholera

Cholera is a diarrheal disease that results from colonization of the small intestine by the Vibrio cholerae organism. The disease is spread primarily by means of fecal contamination of drinking water and may begin with the sudden onset of profuse, watery diarrhea. Vomiting, rapid dehydration, acidosis, muscular cramps and circulatory collapse are other prominent features of severe cholera. Diagnosis is confirmed by identification of the organism in a stool specimen. Treatment requires immediate replacement of the massive fluid loss before diagnostic studies are ordered. Clinicians should suspect cholera in any case of massive, shock-producing diarrhea, especially if the patient has traveled to a cholera-affected country. This article presents epidemiology and public-health measures, pathophysiology, diagnosis, clinical signs and symptoms, and treatment modalities for adults and children infected with the V. cholerae organism.