Cholera physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]

## Overview

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Signs of cholera on physical examination depend on the patient's level of dehydration. Cholera patients may present with tachycardia, postural hypotension, somnolence, dry mucous membrane, sunken eyes, and/or oliguria. If severe diarrhea and vomiting are not aggressively treated, they can, within hours, result in life-threatening dehydration and electrolyte imbalances. The typical symptoms of dehydration include dizziness (due to low blood pressure), wrinkled hands (due to poor skin turgor), sunken eyes, muscle cramps (due to hypokalemia), and decreased urine output.

## Physical Examination

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The presentation of cholera upon physical examination depends on the patient's level of dehydration.

### Vitals

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* Weak or absent pulse; tachycardia
* Postural hypotension

### Appearance of the Patient

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* Somnolence and coma
* Dry mucous membrane

### Skin

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* Wrinkled skin

### Eyes

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* Sunken eyes

## Assessment of Dehydration

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Mental status  | Eyes  | Thirst  | Skin pinch  | Conclusions

|
|
|
|

Normal, alert  | Normal, hydrated  | Normal  | Goes down quickly (spontaneously)  | No / Mild dehydration
Irritable  | Sunken  | Drink eagerly  | Goes back slowly (< 2 sec)  | Some / Moderate dehydration (in case if 2 of the symptoms are present)
Severe  | Sunken  | Drinks poorly  | Goes back slowly (> 2 sec)  | Severe dehydration (in case if 2 of the symptoms are present)

## References

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