A patient, a 27-year old man, has severe vomiting and copius diarrhea - he is pr

Question

A patient, a 27-year old man, has severe vomiting and copius diarrhea - he is producing large volumes of watery diarrheal discharge that is milky-white in color, resembling water that has had rice cooked in it. He lives 30 minutes from the nearest hospital. Based on this information, what would be the correct course of action?

A. No treatment is needed - the disease will resolve in a few hours.

B. Give him oral redydration fluid.

C. Give him broad-spectrum antibiotics.

D. Give him narrow-spectrum antibiotics.

E. Transport him to the hospital immediately for intravenous rehydration.

Explanation / Answer

B. Give him oral redydration fluid.

(The symptoms of the patient resemble Cholera which is an acute infectious disease caused by a bacterium,Vibrio cholerae (V. cholerae), The symptoms and signs of cholera are a watery diarrhea that often contains flecks of whitish material (mucus and some gastrointestinal lining [epithelial] cells) that are about the size of pieces of rice. The diarrhea is termed "rice-water stool". The volume of diarrhea can be enormous; high levels of diarrheal fluid such as 250 cc per kg or about 10 to 18 liters over 24 hours for a 154-pound adult can occur. People may go on to develop one or more of the following symptoms and signs: Watery diarrhea (sometimes in large volumes), Rice-water stools, Fishy odor to stools, Vomiting, Rapid heart rate, Loss of skin elasticity, Dry mucous membranes (dry mouth), Low blood pressure, Thirst, Muscle cramps (leg cramps, for example), Restlessness or irritability (especially in children), Unusual sleepiness or tiredness etc.Those infected require immediate hydration to prevent these symptoms from continuing because these signs and symptoms indicate that the person is becoming or is dehydrated and may go on to develop severe cholera. .People with severe cholera can develop severe dehydration, leading to acute renal failure, severe electrolyte imbalances (especially potassium and sodium), and coma. If untreated, this severe dehydration can rapidly lead to shock and death. Severe dehydration can often occur four to eight hours after the first liquid stool, ending with death in about 18 hours to a few days in undertreated or untreated people. In less extreme situations, people who don't receive treatment may die of dehydration and shock hours to days after cholera symptoms first appear. The CDC (and almost every medical agency) recommends rehydration with ORS (oral rehydration salts) fluids as the primary treatment for cholera.)

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