Depending on the severity of the disease and dehydration degree, five forms of cholera are distinguished. Each form of the disease has its own characteristics. Common symptoms are frequent liquid stools by type «Rice beam».
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Symptoms of dehydration during cholera
The incubation period cholera ranges from several hours to 5 days (more often than 2-3 days). In terms of severity, clinical manifestations are distinguished by an ether, light, moderate gravity, heavy and very heavy forms. The severity of the disease is determined by dehydration. Select the following dehydration degrees:
- I degree when patients lose fluid volume equal to 1-3% body weight (erased and light shapes)
- II degree - loss reach 4-6% (secondary severity form)
- III degree - 7-9% (heavy)
- IV dehydration degree with a loss of over 9% corresponds to the very heavy flow of cholera
Manifestations of erased shape cholera
With erased, cholera forms can only be a single liquid chair with well-being of patients and the absence of dehydration. In more pronounced cases, the disease begins acutely without fever and other preceding phenomena. The first signs of cholera are a sudden calling for the defecation and the extension of cascidious or, from the very beginning, watery detergents. Subsequently, these imperative calls are repeated, they are not accompanied by painful sensations. Felings are emitted easily, the intervals between defecates are reduced, and the volume of detergents increases each time.
Footing have appearance «rice water» - Translucent, Mutno-white painting, sometimes with floating cereals of gray, odorless or with a smell of fresh water. The patient notes the rice and unpleasant sensations in the umbilical area. With a light form of cholera, the defecation is repeated not more often than 3-5 times a day, the overall feeling remains satisfactory, the feeling of weakness, thirst, dryness in the mouth. Duration of the disease is limited to 1-2 days.
Symptoms of Middle Cholera
With moderate severity (dehydration of the second degree), the disease progresses, vomiting is attached to diarrhea, increasing frequency. Massows have the same kind «Rice beam», Like feces. It is characteristic that vomiting is not accompanied by any voltage and nausea. With the joining of vomiting dehydration - Exicosis - quickly progresses. Thirst becomes painful, dry tongue with «chalk touch», The skin and the mucous membranes of the eyes and the oraloglotka are pale, the turgor of the skin decreases, the amount of urine decreases down to Anuria - a sharp decrease in the amount of urine released. Chair up to 10 times a day, abundant, in volume does not decrease, but increases. Single cramps of calf muscles, brushes, stop, chewing muscles, unstable cyanosis of lips and fingers, hoarseness of voice. The disease in this form lasts 4-5 days.
Symptoms of heavy cholera
The cholera heavy form (III dehydration) is characterized by sharply pronounced signs of the excacosis (dehydration) due to very abundant (up to 1-1.5 l for one defecation) of the chair, which becomes such from the first hours of the disease, and the same abundant and multiple vomiting. Patients bother the painful convulsions of muscles of limbs and abdominal muscles.
The voice is weak, thin, often a little heard. The turgor of the skin is declining, the skin collected into the fold is not cracking for a long time. Leather brushes and stop becomes wrinkled - «Hand lark». The face takes a characteristic kind of cholera view - the punished features of the face, the eyes of the eyes, the cyanosis of the lips, the oars, the stumps of the ears, the nose.
Tahipne appears - rapid breathing, tachycardia increases to 110-120 wt / min. Pulse of weak filling («filiform»), the tones of the heart is deaf, hell is progressively falling below 90 mm RT. Art. first maximum, then minimal and pulse. The temperature of the body is normal, the urination is reduced and stopped soon. Blood thickening is expressed moderately.
Very severe cholera
Very severe cholera form (previously called algeid) is distinguished by the rapid sudden development of the disease, beginning with massive continuous defecations and abundant vomiting. After 3-12 hours, the patient develops a severe condition of an algeid, which is characterized by a decrease in body temperature to 34-35.5°With, extreme dehydream (patients lose up to 12% body weight - dehydration of IV degree), shortness of breath, anuine and hemodynamic disorders by type of hypovolemic shock.
By the time of the entry of patients in the hospital, they develop partares of the muscles of the stomach and intestines, as a result of which patients stop vomiting (replaced by convulsive and diarrhea (gaping anus, free expiration «Intestinal water» From the posterior hole with a slight pressure on the front abdominal wall).
Diarrhea and vomiting arise again against the background or after the end of rehydration - measures to combat depletion. Patients are in a state of prostration, drowsiness goes to the opposite, further to whom. The disorder of consciousness coincides in time with a violation of respiratory - from frequent surface to pathological types of breathing.
Skin coloring in such patients acquires ash tint (total cyanosis), appear «Dark glasses around the eyes», The eyes of the smeared, skewers dull, the look is nothing, there is no voice. Cold and sticky skin on the touch, the body is reduced by convulsions (posture «Fighter» or «Gladiator» As a result of common tonic convulsions). The belly is drawn, when palpation is determined by a convulse reduction of the live abdominal muscles. Convulsions are painfully strengthened even at mild abdominal palpation, which causes the concern of patients.
Cholera heavy forms are more often celebrated at the beginning and in the middle of the epidemic. At the end of the outbreak and in the inter-epidemic time, light and erased forms are predominant, non-dissentible from diarrhea of another reason.
