What is the main cause of acute watery diarrheal attack?

BSF Staff Nurse - 2015

Applied Microbiology & Infection control

Easy

Appeared in: BSF Staff Nurse - 2015

Explanation

Vibrio cholerae is the bacterium responsible for cholera, the classic example of a severe, acute watery diarrheal disease.
Cholera is characterized by the sudden onset of profuse, painless, watery stools often described as having a "rice-water" appearance.
The infection leads to rapid and severe fluid and electrolyte loss, which can cause dehydration, metabolic acidosis, hypokalemia, and hypovolemic shock if not treated promptly.
The severe diarrhea is caused by the cholera toxin (CTX) produced by the bacterium, which activates adenylate cyclase in intestinal cells, leading to massive secretion of chloride and water into the intestinal lumen.

Option B: Salmonella typhi causes typhoid fever, a systemic illness where high fever and abdominal pain are the primary symptoms. Diarrhea can occur, but it is typically greenish-yellow ('pea-soup' diarrhea) and may even be preceded by constipation.
Option C: The genus Corynebacterium is most famously associated with Corynebacterium diphtheriae, the agent of diphtheria. Diphtheria is a respiratory infection characterized by a sore throat, fever, and an adherent pseudomembrane in the throat. It is not a cause of diarrheal disease.
Option D: While certain strains of Escherichia coli, particularly Enterotoxigenic E. coli (ETEC), are a very common cause of watery diarrhea (notably traveler's diarrhea), the illness is generally less severe and voluminous compared to the profuse diarrhea seen in cholera.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Acute Watery Diarrhea as background academic context rather than a clinical decision trigger.
Rapid assessment for signs of dehydration (e.g., sunken eyes, poor skin turgor, tachycardia, hypotension) is a critical nursing priority in any patient with acute watery diarrhea.
The cornerstone of cholera management is aggressive rehydration. Nurses must be proficient in administering Oral Rehydration Solution (ORS) for mild-to-moderate cases and initiating intravenous fluids (like Ringer's Lactate) for severe dehydration.
Cholera is a notifiable disease in India. Nurses play a key role in identifying suspected cases and alerting public health authorities to initiate contact tracing and prevent large-scale outbreaks.

How to Approach the Question

First, analyze the keywords in the question: "main cause" and "acute watery diarrheal attack." The term "attack" suggests a severe, sudden onset.
Next, evaluate each option based on the primary disease it is known to cause.
Recall that Vibrio cholerae is the textbook cause of cholera, which is defined by its profuse, watery diarrhea ("rice-water stools") leading to rapid dehydration.
Consider the other options. Salmonella typhi causes typhoid fever (systemic illness with fever). Corynebacterium causes diphtheria (respiratory illness). E. coli can cause watery diarrhea, but it is not typically as severe as cholera.
Based on this comparison, Vibrio cholerae is the pathogen most strongly associated with severe, acute watery diarrhea, making it the best answer.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 788-790

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 78-80