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Bartonella

Essentials of Diagnosis • Key signs and symptoms include dermal lesion (bacillary angiomatosis and chronic phase of Bartonella bacilliformis infection); papule at inoculation site followed by proximal lymphadenopathy (cat scratch disease); fever, bacteremia, acute hemolytic anemia (acute phase of B bacilliformis infection); persistent or relapsing fever (fever and bacteremia/endocarditis). • Predisposing factors include louse exposure, low income, and homelessness (Bartonella quintana-associated bacillary angiomatosis, fever, and bacteremia/endocarditis); cat exposure (cat scratch disease and Bartonella henselae-associated bacillary angiomatosis, fever and bacteremia/endocarditis); sandfly exposure in endemic areas of South American Andes (B bacilliformis infection). • History of HIV or immunocompromise (bacillary angiomatosis). • Key laboratory findings include small, curved, pleomorphic weakly gram-negative bacilli, best …

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Fever & Bacteremia/Trench Fever/Endocarditis

The four Bartonella species that are pathogenic for humans are capable of causing sustained or relapsing bacteremia accompanied by only fever (Table 1). All except B bacilliformis also cause endocarditis. After B quintana enters the body through broken skin from the excreta of the infected human body louse (Pediculus humanus), there is an incubation period of between 5 and 20 days before the onset of trench fever. Patients complain of fever, myalgias, malaise, headache, bone pain — particularly of the legs, and a transient macular rash. Usually the illness continues for 4-6 weeks. Sustained or recurrent bacteremia is common, with or without symptoms. The form of trench fever described in the …

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Rickettsialpox

Essentials of Diagnosis • Eschar at site of mite bite. • Regional lymphadenopathy. • Generalized erythematous papulovesicular eruption on the trunk, extremities, and mucous membranes 9-14 days after exposure. • Systemic symptoms including chills, fever, myalgias, anorexia, and photophobia. • Prediposing factors include urban dwelling in close proximity to house mice. • Serology for R rickettsii will cross-react with antibodies to Rickettsia akari. General Considerations Rickettsialpox has been reported infrequently in the United States. This disease is a mild, self-limited illness caused by R akari and is transmitted to humans by a house mite. Both the house mouse and house mite are reservoirs for the organism. Clinical Findings A painless papule …

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Rocky Mountain Spotted Fever

Essentials of Diagnosis • Key symptoms and signs: abrupt onset of high fevers, headaches, myalgias, malaise, and a flu-like illness 3-12 days after tick bite; rash (80-90% of patients, initially maculopapular, then petechial, classically involving the palms and soles). • Predisposing factors: tick exposure (April through September), pet owners, animal handlers, and outdoor activities. • Commonest geographic location of infection: rural. • Confirmatory serology via IFA. • PCR with blood or skin biopsy: sensitive and specific but not widely available. General Considerations RMSF is caused by Rickettsia rickettsii and is an acute tick-borne illness occurring during seasonal tick activity. The disease is characterized by acute onset of fever, headache, and a …

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Ehrlichia Infection (Ehrlichiosis)

Essentials of Diagnosis • Key symptoms and signs: abrupt onset of high fever, headache, myalgias, chills 8-9 days after tick bite; rash (36% of human monocytic ehrlichiosis [HME] patients; only 2% of human granulocytic ehrlichiosis [HGE] patients); central nervous system involvement (20-25% of patients). • Predisposing factors: tick and rural exposure (April through September). • Presentation: most present as flu-like illness. • Key laboratory features: thrombocytopenia, leukopenia, and elevated liver transaminases. • Diagnosis: confirmed by a fourfold or greater rise in titers with an IFA. General Considerations Human ehrlichiosis was first recognized in the United States in 1986 as a life threatening tick-borne illness similar to Rocky Mountain spotted fever (RMSF), …

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Coxiella, Ehrlichia, & Rickettsia

Coxiella, Ehrlichia, and Rickettsia spp. are small, obligate intracellular bacteria that usually cause disease when they accidentally encounter a human host. Once inside a host cell, Coxiella and Ehrlichia spp. remain within a vacuole where they progress through distinct developmental stages; in contrast, the Rickettsia spp. escape the endocytic vacuole and replicate within the host cell cytoplasm. Ehrlichia and Rickettsia spp. are transmitted by arthropod vectors. COXIELLA BURNETII INFECTION (Q FEVER) Essentials of Diagnosis Acute Infection • Key symptoms and signs: fever, severe headache, myalgias, arthralgias, retrobulbar pain, cough; possible pneumonitis and hepatitis on examination. • Predisposing factors: occupation as a dairy farmer, abattoir worker, or veterinarian; exposure to parturient or …

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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 …

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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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Yersiniosis

Essentials of Diagnosis • Suspected in a child living in or traveling from a high-prevalence area who has fever, abdominal pain, and diarrhea followed by a reactive polyarthritis. • Yersinia spp. are recovered from cultures of specimens of stool, mesenteric lymph nodes, blood, or abscess material. • Inoculation of duplicate sets of cultures for incubation at 37 and 25 °C, respectively, enhances recovery of the microorganisms. General Considerations A. Epidemiology. Conditions that are associated with increased risk for Yersinia spp. infections (yersiniosis) include iron overload states (such as in patients who receive chronic blood transfusions or those with hemochromatosis) and the use of desferrioxamine, a bacterial siderophore. Infections caused by Y …

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Plague

Essentials of Diagnosis • Suspected in patients living in or traveling from an endemic area who have acute onset of fever, prostration, and tender adenopathy. • Yersinia pestis may be recovered from blood cultures or cultures of an aspirate from buboes or sputum in the pneumonic form in 80%-100% of cases. • Gram stains of bubo aspirate or sputum demonstrate the characteristic bipolar “safety pin” gram-negative microorganisms. • Y pestis grows aerobically on most culture media after 48-72 h of incubation. General Considerations The genus Yersinia, named after Alexander Yersin (1863-1943), includes Y pestis, Y enterocolitica, and Y pseudotuberculosis. Y pestis is the cause of plague, a disease that has left …

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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 Chloramphenicol *:

CAF, CAM, CAP, Chloramfenikol, Chloramphenicole, Chloroamphenicol, Cloroamfenicolo, CPh, D-Chloramphenicol

* 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 Chloramphenicol:

Name, Strength, Form, Route
Chloramphenicol Liquid Ophthalmic
Chloramphenicol Ointment Ophthalmic
Chloramphenicol Powder, for solution Intramuscular
Chloramphenicol Solution Ophthalmic
Chloramphenicol Solution / drops Ophthalmic

Therapeutic classes of Chloramphenicol:

Anti-Bacterial Agents, Protein Synthesis Inhibitors

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