Anish was looking for a way to spend his summer break,so he decided to volunteer with a medical mission team going tostaff a clinic in an impoverished rural region of India. At thebriefing meeting, Anish and the other volunteers were warned thatwith the onset of the rainy season in August, they would be seeingpatients with cholera, an acute diarrheal disease caused by thebacterium Vibrio cholera. Toxins from the cholera bacterium causevomiting and massive volumes of watery diarrhea in people whoconsume contaminated food or water. Unless treated promptly,cholera can be fatal.
Cholera is endemic in parts of India, meaning that itoccurs on a regular basis. A volunteer trained by the U.S. Centersfor Disease control and prevention (CDC) spoke to the medicalmission team about what to expect when treating patients and alsoabout proper precautions for themselves. He explained that the oralcholera vaccine they had taken would protect against the O1 strainsbut the area they would be visiting also had the newer O139 strainnot covered by the vaccine. Once in India, everything went well atthe clinic initially. Then about five days into his trip, Anish hasseveral bouts of copious and watery diarrhea. When he developeddizziness and a rapid heartbeat, he visited the medical officer forthe team. There, he was diagnosed with dehydration fromcholera-induced diarrhea.
Given Anish’s watery diarrhea, what would you expect hisECF volume to be?
Why was Anish experiencing a rapidheartbeat?
Esomeprazole is a proton pump inhibitor. For whatsymptom or condition might Anish have been taking thisdrug?
Why might taking a protein pump inhibitor likeesomeprazole have increased Anish’s chances of contractingcholera?
Why would continuously open enterocyte CFTR channelscause secretory diarrhea and dehydration in humans?
Which type of IV solution would you select for Anish,and why? Your choices are normal (isotonic) saline, half-normalsaline, and 5% dextrose in water (D-5-W).
