Paracholera
Introduction
Introduction to Deputy Cholera Paracholera is a potent intestinal infection caused by the classical biotypes of Vibrio cholerae and the ElTor biotype. Enterotoxin produced by Vibrio is a major cause of disease. The clinical manifestations vary in severity. Patients with severe illness have severe vomiting, rice bran-like stools, rapid loss of large amounts of water and electrolytes, low-volume shock, metabolic acidosis, and acute renal failure. Patients with untreated or untimely treatment have a higher mortality rate. The incidence is mostly in summer and autumn, and the epidemic areas can occur all year round. It is more common in coastal areas, rivers and water networks. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: acute pulmonary edema metabolic acidosis uremia
Cause
Cause of cholera
Enterotoxin produced by Vibrio is a major cause of disease.
Prevention
Cholera prevention
1, found the patient, isolation treatment on the spot.
2, pay attention to drinking water, food hygiene.
3, fly, fly.
4, pay attention to rest, light and easy to digest diet.
Complication
Paracholerer complications Complications acute pulmonary edema metabolic acidosis uremia
1, renal failure: due to shock can not be corrected in time and hypokalemia caused by the reduction of urine output and azotemia, severe cases of urinary closure, can die from uremia.
2, acute pulmonary edema, metabolic acidosis can lead to high blood circulation, the latter is also aggravated by the addition of a large amount of alkali-free saline.
3, other low potassium syndrome, arrhythmia and abortion.
Symptom
Symptoms of cholera, common symptoms, diarrhea, nausea and vomiting, hoarseness, tinnitus, irritability, anxiety, indifference
The incubation period is several hours, and the elderly are 3d--5d, usually 1d--2d.
1, typical clinical symptoms first vomiting and vomiting, systemic poisoning symptoms are not obvious, most patients have no fever. There is no obvious abdominal pain, severe symptoms after urgency, and the frequency of bowel movements is often not large (individual patients have incontinence and can not be counted), but the amount of excretion is large, initially mud-like or dilute water-like stools, with feces, and soon rice-like or The colorless water sample and the washed meat water sample have no obvious fecal odor, and the patient quickly dehydrates. Electrolyte disorders, acidosis, circulatory failure. The patient is irritated, thirsty, hoarse, tinnitus, rapid breathing, unconsciousness or indifferent expression, skin shrinkage, eye socket depression, cheeks deep, wet limbs, decreased urine output, urinary closure, etc. Hemorrhoids, pain, decreased muscle tone, sputum, arrhythmia, etc.
2, atypical symptoms of mild discomfort, daily diarrhea several times, thin stools, fecal matter, occasionally nausea, vomiting. Generally, diarrhea is stopped within 48 hours.
Examine
Deputy cholera check
Laboratory inspection
First, the blood test due to water loss, peripheral peripheral blood concentration, white blood cells and red blood cell counts significantly increased. During the dehydration period, serum potassium, sodium and chloride decreased, inosine and urea nitrogen increased, and carbon dioxide binding decreased.
Second, the stool examination often has no red self-cells.
3. Bacteriology The cholera patients have Vibrio in the feces. The time of sterilization without antibiotics can last for 5d-8d. After 5d, the amount of bacteria decreases rapidly. After using effective antibiotics, the bacteria will decrease rapidly.
1. Hanging drop test The fecal specimen was examined by hanging drop under a dark field microscope, and the bacteria were observed to be shuttle-like (or meteor-like).
2, direct smear examination to take fecal specimens directly smear, Gram stained after microscopic examination, visible cholera-shaped bacteria arranged in a group of fish.
3. Enrichment culture The specimens were inoculated in alkaline peptone water of pH 8, 4 and cultured at 37 ° C for 6 h - 8 h. The smear microscopy was easy to detect bacteria.
Serological examination
1. The serum agglutination titer of the serum agglutination test was positive at 1:1100 or so for about 6 days.
2. Immunofluorescence test specimens were enriched and cultured, and specific fluorescent bodies were added. After 4h-6 hours of culture, the fluorescence microscope was used to observe the special fluorescent bacteria sphere.
3. After the separation test, the sugar fermentation test, the cholera red test and the serum agglutination test are carried out, and the Vibrio cholerae O1 group or the O139 Vibrio can be diagnosed.
4. Braking test The specimens of the shuttle movement under the dark field microscope were mixed. After mixing with the O1 antiserum and the specimen, the shuttle movement was inhibited, indicating that the strain was O1 group, suggesting that it was Vibrio cholerae. Since l992, O139 Vibrio has caused adult cholera epidemics in southeastern India and Bangladesh, so if the motility test is positive and the brake test is negative, it should be positive if it is tested with O139 antiserum. Clinical manifestations are typical and should still be diagnosed as cholera.
Diagnosis
Deputy cholera diagnosis and identification
In summer and autumn, there is a history of close contact in the epidemic area. Drinking raw water, unclean food, history of dinner, surrounding environment and poor personal hygiene conditions can help diagnose.
