Symptoms of cholera

The incubation period of cholera varies from several hours to 5 days, usually 2-3 days. In vaccinated, it can extend up to 9-10 days.

In children of senior school age, the symptoms of cholera practically do not differ from those of adults. Cholera begins acutely, with the appearance of a loose stool, marked weakness and malaise, sometimes dizziness and easy cognition, a slight increase in body temperature. The first clinically pronounced sign of cholera becomes diarrhea, which begins suddenly, more often at night or in the morning. Defecation is painless, abdominal pain is absent or mild. Feces in the first hours may be fecal, but very quickly become watery, plentiful, unclear-white, with floating flakes and in appearance resemble "rice broth". Pathological impurities (mucus, greens, blood) are most often absent. In some cases, the stool can have a greenish, yellowish or even brown hue. In typical cases, stools are an isotonic blood plasma, but the bicarbonate content is twice as high, potassium is 4 times or more than in blood plasma. The frequency of the stool varies - from 3 to 10 times a day or more, and in severe cases the stool is not amenable to counting, and the liquid constantly flows out of the anus. With cholera, stools do not have a feces smell and are very abundant (in adults sometimes up to 1 L). Often, after 3-5 defecations, signs of dehydration develop. Early pain and convulsive twitching in gastrocnemius and chewing muscles, as well as severe muscle weakness, appear. Severe weakness and adynamia are one of the most characteristic and early signs of cholera. Sometimes weakness is accompanied by dizziness.

Following a frequent abundant watery stool, there is profuse repeated vomiting, thirst arises - the patient asks to drink, but when drunk the fluid does not quench thirst, but intensifies vomiting. Vomiting often begins suddenly, without nausea. Initially, vomitive masses contain food residues, an admixture of bile, but very quickly become watery and resemble a "rice broth", more rarely - "meat slops".

Pain in the abdomen in the initial period of cholera is uncharacteristic for cholera. The pain syndrome in cholera is mainly associated with convulsive twitching of the abdominal muscles or concomitant gastrointestinal pathology. The abdomen in patients with cholera, as a rule, is involved, painless during palpation, bloating is observed with the development of the intestinal paresis.

Indomitable vomiting and profuse diarrhea very quickly (often within the first hours of the onset of the disease) lead to dehydration of the body, and then become less frequent and may even stop completely, and the patient's condition progressively worsens. In this case, the symptoms associated with exsicosis come to the fore: dryness of the skin and mucous membranes, a change in the appearance of the patient, a decrease in the tissue turgor, hoarseness to the aphonia, convulsions, hemodynamic disorders, cyanosis, hypothermia, dyspnea, anuria (algidic state) .

The features of the patient's face are pointed, the eyes are sunken, around the eyes are blue (the symptom of the "glasses"), cyanosis of the nasolabial triangle, acrocyanosis or general cyanosis of the skin, the extremities are cold to the touch, the skin gathers into folds ("washer hand"), straightened out.

As dehydration develops, convulsive twitching of the chewing and calf muscles becomes longer, generalized, tonic.

The increase in dehydration leads to a faster pulse, lower blood pressure, thickening of the blood, hypokalemia, and the development of hypovolemic shock with a sharp violation of hemodynamics and irreversible impairments in the functions of vital organs.

Hypokalemia, blood thickening, hypoxia and metabolic acidosis along with microcirculatory disorders are the main causes of kidney impairment. Acute renal failure is manifested by a prolonged period of oliguria or even anuria. With the timely initiation of rehydration therapy, uremic condition (or to whom) is rarely observed.

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