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Borrelia & Leptospira Species

BORRELIA SPECIES RELAPSING FEVER Essentials of Diagnosis The most common presentation is fever with rash, headache, shaking chills, myalgias, arthralgias, and — during the acute phase — hepatosplenomegaly. Louse-borne relapsing fever (LBRF) is epidemic, caused by B. recurrentis, and characterized by one or two relapses. Tick-borne relapsing fever (TBRF) is endemic, caused by several Borrelia species, and characterized by multiple clinical relapses. Organisms can be visualized in blood smears of febrile patients, unlike other spirochetal pathogens, using dark-field microscopy or Giemsa or Wright stains. Helical (3-10 spirals) spirochetes, 8-30 um × 0.3 um, motile (flagella). Weil-Felix reaction: Proteus OX-K agglutinin titers are elevated (this is more common in LBRF). General Considerations …

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Brucella, Francisella, Pasteurella, Yersinia, & Hacek

BRUCELLOSIS Essentials of Diagnosis • Suspected in patients with chronic fever of unknown etiology who have a history of occupational exposure or come from a high prevalence area. • Leukopenia. • Blood culture or bone marrow cultures on appropriate media. • Serum antibody titer = 1:160. • Polymerase chain reaction. General Considerations Brucellosis (also called undulant fever, Mediterranean fever, Malta fever) is an infection that causes abortion in domestic animals. It is caused by one of six species of Brucella coccobacilli. It may occasionally be transmitted to humans, in whom the disease could be acute or chronic with ongoing fever and constitutional symptoms without localized findings. A. Epidemiology. Brucellosis is transmitted …

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Important Anaerobes

Essentials of Diagnosis • Foul odor of draining purulence. • Presence of gas in tissues. • No organism growth on aerobic culture media. • Infection localized in the proximity of mucosal surface. • Presence of septic thrombophlebitis. • Tissue necrosis and abscess formation. • Association with malignancies (especially intestinal). • Mixed organism morphologies on Gram stain. General Considerations A. Epidemiology and Ecology. Anaerobic bacteria are the predominant component of the normal microbial flora of the human body. The following sites harbor the vast majority of them: • Skin: Mostly gram-positive bacilli such as Propionibacterium acnes • Gastrointestinal tract: In the oral cavity Prevotella spp., Porphyromonas spp., Peptostreptococcus spp., microaerophillic streptococci, and …

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Toxin-Mediated Infections

1. TETANUS Tetanus is a disease of global incidence produced by the toxin of Clostridium tetani. The risk of acquiring it increases in people > 60 years of age and in neonates, especially in Third World countries where poor sanitary conditions predispose to umbilical stump contamination. Immunization campaigns have played a crucial role in bringing about the observed decreasing incidence in the United States. The pathogenesis of tetanus involves the absorption of preformed toxin, or, less commonly, invasion of toxin-producing organisms from contaminated wounds; it may complicate surgical wounds colonized with C tetani. Incubation periods vary depending on the portal of entry. The toxin tetanospasmin blocks the transmission of inhibitory neurons, …

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Vibrio & Campylobacter

VIBRIO INFECTIONS VIBRIO CHOLERAE INFECTIONS Essentials of Diagnosis • History of exposure, particularly travel to endemic or epidemic locales. • Acute onset of voluminous, watery diarrhea, with low-grade fever and mild abdominal pain, which are disproportionate to the amount of diarrhea. • During outbreaks, the presence of straight-to-curved gram-negative bacilli, with a single polar flagellum, in the stool of infected patients. • In wet preparations, these organisms demonstrate a characteristic darting or “shooting star” motility. The identification may be confirmed by motility inhibition with specific antisera. • Cultures of V cholerae from stool with differential media, such as thiosulfate-citrate-bile salts-sucrose (TCBS) medium. • Bacterial growth in nutrient broth, without 1% NaCl …

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Extraintestinal Campylobacteriosis

Clinical Findings A. Signs and Symptoms. Campylobacter fetus, a less frequent cause of enteritis, is the most common cause of extraintestinal disease; other Campylobacter species that may also cause extraintestinal disease include C jejuni, C coli, C laridis, C sputorum, and C hyointestinalis. C fetus infection may manifest as fever, chills, and myalgias, without definitive localization; additionally, this organism displays a propensity to infect vascular structures. Endocarditis, intravascular infection of abdominal aortic aneurysms, and septic thrombophlebitis with vessel necrosis have been reported. Fetal death, even with appropriate antibiotic therapy, may occur. Fetal complications most commonly occur during the second trimester of pregnancy. Additional manifestations may include pericarditis, meningoencepalitis, septic arthritis and …

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Vibrio Cholerae Infections: Clinical Syndromes

Cholera is a fulminant diarrheal disease caused by V cholerae (Box 1). Patients with cholera develop frequent, watery stools, which may reach volumes =1 L/h. If these patients are untreated, they will develop rapid dehydration and electrolyte abnormalities, which may result in death within hours from the onset of disease. Therefore cholera is a medical emergency. V cholerae is noninvasive and produces diarrhea by the elaboration of a potent enterotoxin. This enterotoxin consists of two subunits that have been well characterized. The circular, pentameric B-subunit binds monosialosyl ganglioside residues on the surface of the intestinal epithelial cell and introduces the enzymatic A-subunit into the cytoplasm. The A-subunit functions as an adenosine …

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Haemophilus, Bordetella, & Branhamella Species

HAEMOPHILUS INFLUENZAE & OTHER HAEMOPHILUS SPECIES Essentials of Diagnosis • Haemophilus influenzae is generally acquired via the aerosol route or by direct contact with respiratory secretions. • The most common associated syndromes include otitis media, sinusitis, conjunctivitis, bronchitis, pneumonia, and, to a lesser extent, meningitis, epiglottitis, arthritis, and cellulitis. • Gram stain shows pleomorphic gram-negative coccobacilli. • In cases of meningitis, epiglottitis, arthritis, and cellulitis, organisms are typically recovered from blood, and type-b polysaccharide capsular material may be detected in the urine. • Organisms and type-b polysaccharide capsule may also be present in other appropriate sterile body fluids, such as cerebrospinal fluid (CSF) in meningitis and joint fluid in arthritis. General …

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Branhamella Catarrhalis: Clinical Syndromes

B catarrhalis causes bronchitis and pneumonia in patients with underlying lung disease, especially chronic obstructive pulmonary disease. It is also a rare cause of invasive disease, including meningitis, endocarditis, bacteremia without a focus, septic arthritis, and cellulitis. In addition, it is a recognized cause of acute conjunctivitis and is periodically mistaken as Neisseria gonorrhoeae in newborn infants with conjunctivitis. B catarrhalis occasionally colonizes the genital mucosa and has been reported as a cause of urethritis. Clinical Findings A. Signs and Symptoms. The signs and symptoms of B catarrhalis acute otitis media and sinusitis are indistinguishable from those present when acute otitis media and sinusitis are caused by other pathogens (Box 8). …

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Bordetella Species: Clinical Syndrome

Classical pertussis occurs in three clinical stages: catarrhal, paroxysmal, and convalescent (Box 5). Clinical Findings A. Signs and Symptoms. The catarrhal stage is characterized by nonspecific upper respiratory symptoms, including rhinorrhea, mild cough, and low-grade fever. During this stage, which typically lasts 1-2 weeks, the disease is highly communicable. The paroxysmal stage is marked by sudden attacks or paroxysms of severe, repetitive coughing, often culminating with the characteristic whoop and frequently followed by vomiting. A marked lymphocytosis usually accompanies this stage of the disease, with lymphocyte counts sometimes exceeding 50,000/mm3 and usually representing 70% or more of total circulating leukocytes. The paroxysmal stage typically lasts 1-4 weeks and can be associated …

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Spanish And French Translations Of Common Medication Words:

English Spanish French
Medications Medicamentos Médicaments
Tablets Comprimidos Comprimés
Capsules Cápsulas Gélules
Pharmacies in the United States
Top 10 Pharmacy chains in the U. S. ranked by the number of pharmacists:
1 Walgreens 2 CVS 3 Walmart 4 Rite Aid 5 Kroger
6 Target 7 Kaiser Permanente 8 Sears 9 Cardinal Health 10 Dominick's
Pharmacy-led chains in the United Kingdom
Alliance Boots The Co-operative Lloyds Pharmacy
Numark Rowlands Pharmacy Superdrug

Synonyms of Ampicillin *:

Aminobenzylpenicillin, Ampicilina [INN-Spanish], Ampicillin Acid, Ampicillin Anhydrate, Ampicillin Anhydrous, Ampicillin Base, Ampicillin Sodium, Ampicillin Trihydrate, Ampicillin [Usan:Ban:Inn:Jan], Ampicillina [Dcit], Ampicilline, Ampicilline [INN-French], Ampicillinum [INN-Latin], Anhydrous Ampicillin, Bayer 5427, D-Ampicillin

* Official titles and synonyms used in the British, European, and US Pharmacopoeias. INNs in the other main official languages (French, Latin, and Spanish) have also been included in the list of synonyms where these differ from the English INN.

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Dosage forms of Ampicillin:

Name, Strength, Form, Route
Ampicillin Capsule Oral
Ampicillin Liquid Oral
Ampicillin Powder, for solution Intramuscular
Ampicillin Powder, for solution Intravenous
Ampicillin Powder, for solution Oral
Ampicillin Suspension Oral
Ampicillin Tablet Oral

Therapeutic classes of Ampicillin:

Anti-Bacterial Agents, Penicillins

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Common brands (equivalents) of Ampicillin, which people buy in pharmacies of the world:

(The World's Largest Pharmaceutical Companies: Abbott, Amgen, AstraZeneca, Baxter, Bayer, Bristol-Myers Squibb, Boots, CSL, Eli Lilly, Forest, GlaxoSmithKline, Hoffmann - La Roche, Johnson & Johnson, Merck & Co., Mylan, Novartis, Pfizer (with Wyeth), Sanofi - Aventis, Sandoz, Solvay, Takeda, Teva, UCB, Watson)
(Australia, Canada, India, Mexico, New Zealand, USA, Europe [Belgium, France, Germany, Holland, Ireland, Spain, Switzerland, Great Britain (UK), Italy], and etc)
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