Summary
Definition
History and exam
Key diagnostic factors
- diarreia aquosa copiosa
- evidências de depleção de volume
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
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
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
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
Treatment algorithm
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
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
- Laboratory testing for cholera
- Recommendations for the use of antibiotics for the treatment of cholera
More GuidelinesPatient information
Diarreia em crianças
Diarreia em adultos
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