Microbial Diseases Man Does Not Produce Diarrhea
Microbial Diseases Man Does Not Produce Diarrhoea but is responsible for bacteria, abortion, pneumonia, endocarditis, thrombolytic, and an illness resembling acute tuberculosis. Treatment. The treatment of cholera is the replacement of the fluid and electrolyte depletion attributable to severe diarrhea. return the plasma specific gravity toward normal. The hemoglobin or crematoria determination may be, misleading, because of lire-existing anemia.
Plasma protein concentration, and particularly plasma specific gravity, can usually serve as a reliable index for the administration of fluids and electrolytes. of fluid per kilogram of body weight. This volume of fluid should be given promptly as isotonic (0.85 percent) sodium chloride and 2 percent sodium bicarbonate in a ratio of 2 or 3 to 1 by volume, administered intravenously. Giving fluids equal to 10 percent of the patient's body weight (three-quarters of this to be given rapidly) is usually adequate for initial treatment. Lifters initial hydration, the fetal less, measured hourly, should be replaced volume for volume with the same saline and alkali combination as given initially.
The plasma specific gravity should be measured every eight hours, at least, during the first day and once daily thereafter until the patient ‘has fully recovered. At that time potassium, as juices or in another form, may be fed. Otherwise, if diarrhea continues for more than 24 hours, the intravenous fluids should contain- 10, etc. of potassium chloride per liter. Tetracycline in a dosage of 100 mg. during the first day of treatment shortens the period of diarrhea, decreases the requirement for fluid replacement. cholera from the feces. Prognosis. The case mortality rate from un-treated cholera in persons 10 to 20 years of age is 50 percent; in persons over 50, it is 70 percent. Death is more common among those less than 10 years of age than among patients between 10 and 20 years of age.
Almost invariably, death can be prevented if the fluid, electrolyte, and alkali therapy is begun early in the illness, and if there is no serious associated disease or renal failure. Prevention. In those parts of the world where water supply and sewage disposal are controlled effectively, cholera no longer occurs. There is a killed bacterial vaccine for immunization against cholera that provides some temporary protection.
Carpenter, C. C. J., et al.: Clinical studies in Asiatic cholera_ Bull. Hopkins Hosp., 118:165, 1966. Gangarosa, E. J., Beisel, W. R., Benyajati, C., Sprinz, H., and Piyaratn, P.: The nature of the gastrointestinal lesion in Asiatic cholera and its relation to pathogenesis: A biopsy study. Amer. J. Trop. Dis., 9:125, 1960. McIntyre, 0. R., Feeley, J. C., Greenough, W. B., III, Benenson, A. S., Hassam, S. I., and Saad, A.: Diarrhea caused by non-cholera vibrios. Amer. J. Trop. Med., 14:412, 1966. Season, R. 0., Benenson, A. S., and Fahimuddiri, M.: Field trial of cholera vaccine in rural East Pakistan. Lancet, 1:450, 1965. Phillips, R. A.: Water and electrolyte losses in cholera. Fed. Proc., 23:705, 1964. Phillips, R. A.: Asiatic cholera. Ann. Rev. Med., 19:69, 1968. Snow, J.: Snow on Cholera. The Commonwealth Fund. London, Oxford University Press, 1936.
PLAGUE Fred R. McCrumb, Jr.
Definition. Plague is an acute or chronic dis-ease of wild and commensal rodents transmissible among these lower animal hosts and to man through the bite of infected ectoparasites. Secondary or embolic pneumonia may result in the direct respiratory spread of the disease from man to man. produce overwhelming sepsis and primary plague pneumonia. Etiology. on blood agar.