Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- diarreia aquosa copiosa
- evidências de depleção de volume
Outros fatores diagnósticos
- idade <5 anos
- ingestão de frutos do mar
- história familiar de recente doença grave similar à cólera
- vômitos
- febre
- dor abdominal
- letargia ou coma
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Hemograma completo
- eletrólitos séricos
- ureia e creatinina séricas
- lactato sérico
- gasometria arterial
- eletrocardiograma
- microscopia de campo escuro/contraste de fases das fezes
- testes diagnósticos rápidos de fezes
Investigações a serem consideradas
- 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
Algoritmo de tratamento
depleção de volume de leve a moderada: sem vômitos
vômitos ou depleção de volume grave
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
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.
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.
References
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.
Differentials
- Outra diarreia infecciosa
- Disenteria amebiana
- Strongyloides e outros helmintos intestinais
More DifferentialsGuidelines
- WGO practice guideline: acute diarrhea
- First steps for managing an outbreak of acute diarrhoea
More GuidelinesPatient information
Diarreia em adultos
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