Related Experiment Videos
Clinical profile of cholera in young children--a hospital based report
1Diarrhea Training and Treatment Unit, Lady Hardinge Medical College, New Delhi.
Insights
Cholera affects young children, with key symptoms including watery stools and severe dehydration. Early diagnosis and investigation are crucial, even in non-outbreak areas.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Cholera is a significant cause of acute watery diarrhea in children.
- Early recognition and diagnosis of cholera in pediatric populations are critical for effective management.
Purpose of the Study:
- To investigate the clinical profile and diagnostic parameters of cholera in young children.
- To assess the etiological agents and antimicrobial susceptibility patterns of V. cholerae in pediatric cases.
Main Methods:
- Retrospective analysis of clinical data from 8714 cases of acute watery diarrhea in children.
- Stool culture for V. cholerae identification and hanging drop method for rapid diagnosis.
- Antimicrobial susceptibility testing of V. cholerae isolates.
Main Results:
- 64 children (0.7%) were suspected of having cholera, with V. cholerae 01 Ogawa confirmed in 33 cases (51.6%).
- Children under 5 years accounted for 64% of culture-positive cases, with infants as young as 3 months affected.
- Significant clinical indicators for cholera included frequent watery stools, vomiting, and severe dehydration. The hanging drop method showed high specificity (100%) and positive predictive value (100%).
Conclusions:
- Cholera is not uncommon in infants and young children, presenting with similar symptoms as older children.
- Clinical suspicion should be high for acute watery diarrhea with rapid dehydration in young children, regardless of location or outbreak status.
- Prompt investigation and appropriate antimicrobial therapy are essential for managing pediatric cholera cases.
Abstract:
Clinical profile of cholera was studied in children attending Diarrhea Training and Treatment Unit from January-December 1993. Out of a total 8714 cases of acute watery diarrhea, 64 children (0.7%) were suspected to have cholera on the basis of acute onset loose water/rice watery stools, high purge rate with or without excessive vomiting and/or severe dehydration. Stool culture was positive for cholera in 33 cases (51.6%). All the isolates were V. cholerae 01 biotype El Tor serotype Ogawa. Sixty four per cent of stool culture positive cases were below 5 years of age. The results assume importance because out of 28 children < 2 years with clinical suspicion of cholera, 11 cases (39.3%) were culture positive for V. cholerae, youngest child being 3 months old. Comparison of various parameters revealed that presence of vomiting > 4 episodes/ day (p < 0.005), frequency of stools >12/24 hours (p <0.002), rice watery stools (p < 0.01) and presence of severe dehydration (p < 0.01) were significant parameters associated with positive stool culture. Beside examination of stool sample by hanging drop method was an excellent diagnostic tool (p < 0.001) with a sensitivity of 51.5%, specificity 100% and positive predictive value of 100%. The isolates of V. cholerae were susceptible to furazolidone, cephelexin, nalidixic acid, norfloxacin and gentamicin. Our observations indicate that cholera is not uncommon in infants and young children. Like children in the older age group, acute onset diarrhea with watery/rice watery stools and high purge rate with or without excessive vomiting and/or rapid development of severe dehydration should arouse suspicion of cholera in younger children also. They should be investigated for cholera even in non-endemic areas and in the absence of cholera outbreaks.