Cholera

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Author:
ehamm
ID:
117515
Filename:
Cholera
Updated:
2011-11-17 12:45:35
Tags:
Cholera
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Description:
Cholera
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  1. Organism
    • Low tolerance for acid, grows under alkaline conditions
    • Distinguished by LPS, O Ag, and production of Cholera toxin
    • O1=eltor, O139 cause cholera
    • Toxin coregulated pilus, expression regulated with CT
  2. Toxin
    • ADP-R toxin
    • B=GM1-ganglioside receptor
    • Binds Gs, keeps it activated
    • Increases cAMP -> hypersecretion of chloride
  3. Epidemiology
    • Contaminated water
    • Endemic in India, Africa
    • Human carriage brief, incubation =1-2 days
    • Inadequately cooked shellfish
  4. Pathogenesis
    • Colonizes jejenum to colon
    • Surface pili adhesion factors
    • Cholera toxin
    • Outpourin of fluid, electrolytes greatest in Small Intestine
    • Same sodium content, 2-5x K and HCO3 content
    • Dehydration, hypokalemia
    • Not altered mucosa
    • Transmembrane protein ToxR regulates TCP and CT responds to environment changes
  5. Manifestations
    • Rapdi onset
    • Fullness, discomfort, loose stools
    • Watery, volumness, odorless, rice water stools
    • No pus or blood, afebrile
    • Dehydration, hypotension, death
  6. Diagnosis
    • Isolation from stool
    • Selective media
  7. Treatment
    • Supportive
    • Rehydration
    • Doxycycline shortens duration

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