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Giardia: Clinical Syndromes

After ingestion of G lamblia cysts, 5-15% of patients will have asymptomatic cyst passage, and 25-50% of patients will have diarrhea. From 35% to 70% of these patients will have no evidence of infection. The three manifestations of infection include asymptomatic cyst passage, self-limited diarrhea, and chronic diarrhea with associated malabsorption and weight loss. Factors related to each of these manifestations are unknown but are believed to be related to specific host factors, parasite load, and virulence variation among G lamblia isolates. 1. ACUTE GIARDIASIS Clinical Findings A. Signs and Symptoms. After ingestion of cysts, an incubation period of 3-20 days exists before symptom onset. At the time of presentation, patients …

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Malaria and Babesia

PLASMODIUM SPP. • Exposure history, such as travel, recent transfusion, or living in close proximity to an international airport. • Nonfalciparum malaria: chills and fever spikes, followed by defervescence and fatigue; symptoms may be cyclic every 48-72 h. • Falciparum malaria: fever spikes and chills, often noncyclic and associated with rapidly progressive systemic symptoms. • Detection and identification of a Plasmodium species in a thick and thin blood smear, respectively. • Molecular detection of P falciparum’s histidine-rich protein by enzyme-linked immunosorbent assay (ELISA) or Plasmodium DNA by polymerase chain reaction (PCR) followed speciation by probe hybridization or DNA sequencing. General Considerations A. Epidemiology. Malaria, a disease of antiquity, was recognized by …

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Nonfalciparum Malaria (P Vivax, P Ovale, P Malariae)

Clinical Findings A. Signs and Symptoms. Patients with nonfalciparum malaria invariably develop fever and chills that may become cyclic. Initially, patients experience chills, which are followed by fever (Box 1). Patients with malaria often manifest many nonspecific symptoms such as weakness, malaise, headache, and myalgias. As the disease progresses, signs of anemia, such as pale conjunctiva, may be seen. Splenomegaly and mild hepatomegaly may also be present. After hours of fever, defervescence occurs with marked diaphoresis. Patients are weakened and exhausted from the severity of the disease. In established infections caused by P vivax and P ovale, a periodicity may occur approximately every 48 h. P vivax and P ovale infections …

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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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Chlamydia

General Considerations Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae are among the most prevalent microbial pathogens in humans worldwide. C trachomatis is responsible for a variety of sexually transmitted disease (STD) syndromes in both sexes. In addition, certain serotypes of C trachomatis are responsible for trachoma, the most common infectious cause of blindness in humans. C psittaci is a zoonotic pathogen associated with atypical pneumonia. C pneumoniae infects approximately one-half of the world’s human population and is a cause of upper and lower respiratory tract disease. It has also been associated with atherosclerotic cardiovascular disease. A. Epidemiology. In the United States, genital infections by C trachomatis serovars D through K occur …

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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 Doxycycline *:

Doxcycline anhydrous, Doxycycline Hyclate, Doxycycline Monohydrate, Doxytetracycline

* 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 Doxycycline:

Name, Strength, Form, Route
Doxycycline Capsule Oral
Doxycycline Gel, metered Periodontal
Doxycycline Tablet Oral

Therapeutic classes of Doxycycline:

Anti-Bacterial Agents, Antimalarials, Tetracyclines

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Common brands (equivalents) of Doxycycline, 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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