Cholera treatment

Treatment of cholera is primarily aimed at compensating for body weight deficit, correcting ongoing losses of water and electrolytes with stool, vomiting and exhaled air. Rehydration therapy is based on the same principles as in the treatment of other intestinal infections with dehydration.

Glucose-salt solutions (Regidron, "Children's Doctor", Glucosolan) are also used for oral rehydration, and Quartasol and Trisol, an isotonic solution of 1.5% Reamberin solution, are used for parenteral rehydration. Solutions for oral use are prepared before use, and drugs for intravenous administration are heated to 37-38 °C. The volume of liquid for oral rehydration (for exicosis of I-II degree) is calculated by the generally accepted method. It is very important to organize an accurate accounting of all water and electrolyte losses, which is achieved by collecting feces and vomit, as well as weighing the child every 4 hours.

If oral rehydration is ineffective or impossible (severe forms of dehydration with signs of hypovolemic shock, prolonged oliguria and anuria with uncontrollable vomiting, impaired glucose absorption in the gastrointestinal tract), intravenous drip administration of fluid (Quartasole or Trisol solutions) is indicated.

• In young children, it is necessary to replenish at least 40-50% of the initial fluid deficit in the first hour of rehydration, which in case of grade III exsicosis does not exceed 1-1.5 l. Subsequently, rehydration is carried out more slowly, at a rate of 10-20 ml/kg for 7-8 hours.
• For children aged 3-4 years, rehydration can be carried out more intensively, the rate of infusion in the first hour can reach 80 ml/kg. At the end of the first stage of rehydration, the child is weighed again and, if rehydration is carried out correctly, the body weight reaches the initial one, but should not exceed it by more than 10%.

The total daily volume of fluid for rehydration therapy (including intravenous) is calculated (as with other acute intestinal infections) using tables or formulas. In young children, the relative density of plasma cannot be used to calculate the required amount of fluid due to the large extracellular volume of fluid.

Forecast

With timely diagnosis and early initiation of adequate rehydration therapy, the prognosis for cholera is favorable in most cases - improvement of the condition and recovery occur very quickly. In severe forms of cholera and decompensated dehydration, especially in young children and newborns, despite timely and adequate therapy, death may occur already in the initial period of the disease. The cause of death may also be the layering of a secondary bacterial infection (most often pneumonia).