7.4
Cholera
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 7, Gastrointestinal Conditions.
Clinical Description
- Bacterial infection caused by Vibrio cholerae
- Causes severe watery, “rice water” diarrhoea and may lead to death
Signs and Symptoms
- Severe watery diarrhea (usually painless, rice water like)
- Vomiting
Investigations
- Usually clinical diagnosis
- Cholera Ag rapid test (stool sample)
Non-pharmacological
- Isolate the patient
- Ensure hygienic precautions by all in contact with patient
- Investigate source of contamination, inform environmental health authorities
- Trace close contacts and give antibiotics as below
Pharmacological
- Rehydration is mainstay of treatment
- Type of resuscitation fluid is less important than quantity of fluid replaced may need 1L/hour initially
- if available, IV Ringer’s Lactate is the preferred fluid of choice
- maintenance fluids after resuscitation: IV fluids and oral rehydration solution (ORS)
Antibiotics can shorten duration of diarrhoea
Adults
- Doxycycline 300 mgSTAT OR Azithromycin 1g STAT
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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