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Cholera

Última revisão: 21 Aug 2025
Última atualização: 04 Jun 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • copious watery diarrhea
  • evidence of volume depletion
Detalhes completos

Outros fatores diagnósticos

  • age <5 years
  • ingestion of shellfish
  • family history of recent, severe, cholera-like illness
  • vomiting
  • fever
  • abdominal pain
  • lethargy or coma
Detalhes completos

Fatores de risco

  • ingestion of contaminated water
  • ingestion of contaminated food
  • inadequate sanitation
  • recent heavy rains and flooding
  • decreased gastric acid secretion
  • blood group O
  • malnutrition
  • HIV infection
  • lack of breast-feeding
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CBC
  • serum electrolytes
  • serum BUN and creatinine
  • serum lactate
  • ABG
  • ECG
  • dark-field/phase-contrast microscopy of stool
  • rapid dipstick testing of stool
Detalhes completos

Investigações a serem consideradas

  • Gram stain of stool
  • stool culture of liquid stool, fecal suspension, or rectal swab
  • serogroup confirmation using antisera
  • antibiogram (sensitivities)
  • enzyme-linked immunosorbent assay (ELISA) assay of stool
  • molecular testing of stool
  • loop-mediated isothermal amplification (LAMP) assay of stool
  • CXR and abdominal x-ray
Detalhes completos

Algoritmo de tratamento

AGUDA

mild-moderate volume depletion: without vomiting

vomiting or severe volume depletion

Colaboradores

Autores

Marcus Eder, MD (Inf Diseases & Microbiology), MRCP, MRCPath, MSc, DTM&H

Scientific Collaborator

Research & Development

Swissnoso (National Center for Infection Control)

Bern

Switzerland

Declarações

ME declares that he has no competing interests.

Rekha Lopez, BSc, MBBS, MRCP, MSc, FRCPath

Consultant Microbiologist

Barking, Havering and Redbridge University Hospitals NHS Trust

Essex

UK

Declarações

RL declares that she has no competing interests.

Agradecimentos

Dr Marcus Eder and Dr Rekha Lopez would like to gratefully acknowledge Dr Justin Green, a previous contributor to this topic.

Declarações

JG is employed by, and holds stock in, GlaxoSmithKline (GSK). GSK has had no involvement in the preparation of this document, and the views expressed are those of the author.

Revisores

David Sack, MD

Professor

Department of International Health

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

Declarações

DS is an author of some studies referenced in this topic.

Nur H. Alam, MD

Scientist

Clinical Sciences Division

International Centre for Diarrhoeal Disease Research

Dhaka

Bangladesh

Declarações

NHA is co-author of a study referenced in this topic.

Jaya Shankar Kaushik, MD

Registrar

Department of Pediatrics

University College of Medical Sciences

New Delhi

India

Declarações

JSK is the author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Sack DA, Sack RB, Nair GB, et al. Cholera. Lancet. 2004 Jan 17;363(9404):223-33. Resumo

World Health Organization. Fact sheet: cholera. Dec 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Cholera images
  • Diagnósticos diferenciais

    • Other infectious diarrhea
    • Amebic dysentery
    • Strongyloides and other intestinal helminths
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Laboratory testing for cholera
    • Recommendations for the use of antibiotics for the treatment of cholera
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Diarrhea in adults

    Diarrhea in children

    Mais Folhetos informativos para os pacientes
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