Water and electrolyte losses due to cholera in infants and small children: a recovery balance study

TLDR: Stool composition in pediatric cholera is compared to that in infantile diarrhea and adult Cholera, and significant differences from each of the latter two are described in this paper.

Abstract: Observational studies were conducted on cases of pediatric cholera in India. The observations obtained through the study provide a clinical and biochemical description of pediatric cholera. They permit also comparison of this disease with other types of acute infantile diarrhea and with cholera in adults. Graphs and tables provide the data on initial and recovery conditions in the study cases. Admission observations include the prior loss of large valumes of bicarbonate-rich watery stool. Most of the cases were admitted in a state of hypovolemic shock. Oral rehydration therapy facilitated complete balance recovery in the 6 study cases. Ileal fluid composition in children with cholera was found to be similar to that in adults except that the carbon dioxide content was significantly lower in the children. In pediatric cholera electrolyte loss is controlled by the short duration of the disease prior to admission. Water and electrolyte deficiencies at the time of admission however were found to be similar to previously reported deficiencies in cases of infantile diarrhea. 2 differences were observed: 1) the sodium deficit was greater relative to the water deficit in the pediatric cholera cases due to higher concentrations of sodium in cholera stools and the limited fluid intake prior to admission; and 2) severe circulatory insufficiency as evidenced by a water deficit was less in pediatric cholera cases. Comparisons were made with adult cholera conditions.