Normal stomach acid can kill Vibrio cholerae, when lack of gastric acid secretion or low, or the invasion of a large number of Vibrio cholerae, Vibrio not kill on into the small intestine, multiply rapidly in the alkaline intestinal fluid and mucus, bacteria dissolving enzymes and adhesion factors such as the role of chemokines attract role the bacterial flagellum activities and Vibrio mucin, adhered to the surface of the small intestinal epithelial cells, and in this large propagation.
The bacteria produce strong exotoxin that cholera toxin A subunit and the B subunit. The B subunit premises mucosal epithelial cell surface receptor - ganglioside binding A the two subunit dissociation, the A subunit into the cell through the cell membrane, the activation of adenylate cyclase (AC) intracellular adenosine triphosphate (ATP ) into cyclic adenosine (cAMP) intracellular cyclic adenosine monophosphate content increased, prompting a series of enzymatic reactions accelerated, resulting in the jejunum to the the ileum Ministry glandular cells secrete hyperthyroidism, caused a lot of liquid and plasma sodium, potassium, chloride ions into the intestine, secretory function over the intestinal absorption capacity, causing severe diarrhea and vomiting; due to the decrease in the secretion of bile, and there is plenty of water, mucus, and electrolytes in the intestine, so the row diarrhea was white "rice water" kind; due to severe vomiting and diarrhea, leading to dehydration and electrolyte loss, caused by potassium deficiency, lack of sodium and muscle spasm; due to loss of bicarbonate ions the acidic metabolites accumulate in the body, causing metabolic acidosis; drastically reduced effective blood volume, blood concentration, leading to decreased urine output, decreased blood pressure, and even shock; due to renal ischemia, hypoxia, intracellular potassium deficiency, resulting in renal tubular epithelial cell degeneration and necrosis, resulting in acute renal failure.
The main lesions by severe dehydration caused clinical the visible fingerprints shrinkage, subcutaneous tissue and muscles shriveled. Heart, liver, spleen and other organs were seen narrowing. The visceral serosa dull. Height expansion of the intestine, intestines filled with swill like fluid, intestinal relaxation, but the mucosal epithelial integrity, no ulcer. Filled with viscous bile in the gallbladder. Glomerular and interstitial capillary dilation, tubular swelling, degeneration and necrosis. Bleeding, degeneration changes in other organs.