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Cholera — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsCholeraSCE Infectious Diseases

A 64-year-old man presents with a 3-day history of severe watery diarrhoea and vomiting. He returned from Bangladesh 2 days ago. He is profoundly dehydrated with sunken eyes, reduced skin turgor, and postural hypotension. Stool microscopy shows darting motility of comma-shaped Gram-negative organisms. What is the priority in management?

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Correct answer: A — Aggressive IV fluid resuscitation with Ringer's Lactate

This presentation is consistent with cholera (Vibrio cholerae — comma-shaped, darting motility). The priority is rapid, aggressive fluid replacement. Cholera can cause fatal dehydration within hours. Ringer's Lactate (Hartmann's) is the preferred IV fluid. Antibiotics (Doxycycline 300 mg single dose is first-line) shorten the duration of diarrhoea and reduce fluid requirements but are adjunctive to rehydration. ORS can be used for milder cases.

Reference: WHO 2024 – Cholera treatment guidelines; UKHSA 2023 – Cholera management