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Cólera

Last reviewed: 24 Jul 2025
Last updated: 04 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • diarreia aquosa copiosa
  • evidências de depleção de volume
Full details

Other diagnostic factors

  • idade <5 anos
  • ingestão de frutos do mar
  • história familiar de recente doença grave similar à cólera
  • vômitos
  • febre
  • dor abdominal
  • letargia ou coma
Full details

Risk factors

  • ingestão de água contaminada
  • ingestão de alimentos contaminados
  • saneamento inadequado
  • chuvas fortes e inundações recentes
  • diminuição da secreção do suco gástrico
  • grupo sanguíneo O
  • desnutrição
  • Infecção pelo vírus da imunodeficiência humana (HIV)
  • ausência de amamentação
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo
  • eletrólitos séricos
  • ureia e creatinina séricas
  • lactato sérico
  • gasometria arterial
  • eletrocardiograma
  • microscopia de campo escuro/contraste de fases das fezes
  • teste rápido de tira reagente das fezes
Full details

Investigations to consider

  • coloração de Gram das fezes
  • coprocultura de fezes líquidas, suspensão fecal ou swab retal
  • confirmação do sorogrupo usando antissoro
  • antibiograma (sensibilidades)
  • ensaio de imunoadsorção enzimática (ELISA) das fezes
  • teste molecular das fezes
  • ensaio de amplificação circular isotérmica (LAMP) das fezes
  • radiografia torácica e radiografia abdominal
Full details

Treatment algorithm

ACUTE

depleção de volume de leve a moderada: sem vômitos

vômitos ou depleção de volume grave

Contributors

Authors

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

Scientific Collaborator

Research & Development

Swissnoso (National Center for Infection Control)

Bern

Switzerland

Disclosures

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

Disclosures

RL declares that she has no competing interests.

Acknowledgements

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

Disclosures

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.

Peer reviewers

David Sack, MD

Professor

Department of International Health

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

Disclosures

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

Disclosures

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

Disclosures

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

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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

World Health Organization. Fact sheet: cholera. Dec 2023 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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