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Cholera.

The causative agent is Vibrio cholerae.

The transmission path is fec-or.

Pathogenesis. It does not have invasive sv-you. With the help of OA / gene - adhesion to the small intestine receptors, colonization of the mucosa, the production of enterotoxin - the irreversible activation of adenylate cyclase - continuous secretion - dehydration.

The incubation period is 2-3 days (up to 5 days).

Clinical picture.

It happens: 1) clinically manifested form, 2) vibrio-bearing.

The beginning is diarrhea. For 1 defecation - 300 ml or more.

Dehydration 1 tbsp.

Thirst, m.p. single vomiting, stool type "rice broth" (without feces).

Dehydration 2 tbsp.

Pale skin, acrocyanosis, dry mucous, stool 10 or more times a day, vomiting (may be repeated), instability of blood pressure, tachycardia, oliguria, m. short cramps, easily cupping rubbing.

Dehydration 3 tbsp.

Dryness of the skin, slime, change of voice to aphonia, cyanosis, marbling of the skin, s-m "glasses", sunken eyes, blood pressure up to 70 mm Hg, orthostat collapse, weak pulse, anuria, indomitable vomiting (fountain), stool 20 times per day, hemoconcentration, hypokalemia, hypochloraemia.

Dehydration 4 tbsp.

AD v below 60 mm Hg, pulse on the periphery is not determined, convulsions (up to the diaphragm), the development of acute renal failure.
This state is reversible!

Diagnostics.

Blood - eritri ^, lake ^ up to 20 thousand - re-t haemoconcentration, ESR ^

Urine is the density of ^.

Cal, vomiting - bact seeding.

Serology is not used.

Treatment.

1. Compulsory hospitalization.

2. Antibiotics - tetracycline, doxycycline for 5 days for 3-4 r / day, nitrofurans, fluoroquinolones, intetriks.

3. Rehydration. It is carried out in 2 stages - 1) replenishment of the vehicle at the time of the inspection (primary rehydr), 2) compensatory ejection. # 1) oral - special r-ry with glyc, drink at a speed of 1 l / h. 2) infusion - at 3-4 st.

Rules of discharge.

After 24-36 hours after the abolition of antibiotics - for 3 consecutive days the test feces - if all 3 samples are negative, examine the bile, if it is negative, then write it out. (8-10 days).
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Cholera.

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