Tags: Isoniazid

Other Mycobacteria

Essentials of Diagnosis Demonstration of the acid-fast bacillus. Infections more common in immunocompromised hosts. Infections mainly pulmonary or soft tissue. General Considerations The increasingly relative importance of the atypical mycobacteria, many of which are ubiquitous in the environment, was recognized with the decline in tuberculous disease. Generally, atypical mycobacteria are unusual causes of disease in patients who are immunocompetent but can in immunocompromised hosts such as AIDS and cancer patients. Most infections caused by atypical mycobacteria are skin and soft tissue abscesses, sometimes following pulmonary infection or implantation of prosthetic devices. There have been a few reports of epidemics of iatrogenic infection with atypical mycobacteria, associated with injection of contaminated materials. …

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Tuberculosis

Essentials of Diagnosis • The cardinal symptoms of tuberculosis (TB) are fatigue, weight loss, fever, and night sweats. • The most commonly infected populations include the homeless, institutionalized patients, and HIV-positive patients. • In most cases, a TB skin test (PPD) is positive. • To establish presence of infection, an acid-fast bacilli (AFB) smear demonstrates the acid-fast bacillus. • In primary pulmonary TB, an infiltrate in the lower lobes of the lung is usually seen on chest x-ray. In contrast, apical lung infiltrates are commonly seen in the reactivation of pulmonary TB. General Considerations Mycobacterium tuberculosis is still an important pathogen. Approximately one-third of the world’s population is infected with M …

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Hepatitis

The causes of hepatitis are varied and include viruses, bacteria, and protozoa, as well as drugs and toxins (eg, isoniazid, carbon tetrachloride, and ethanol). The clinical symptoms and course of acute viral hepatitis can be similar, regardless of etiology, and determination of a specific cause depends primarily on the use of laboratory tests (Box 1). Hepatitis may be caused by at least six different viruses whose major characteristics are summarized in Table 1. Non-A-non-B (NANB) hepatitis is a term previously used to identify cases of hepatitis not caused by hepatitis A or B. With the discovery of hepatitis viruses C, E, and G, most of the viral etiologies of NANB disease …

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Penicillins: Organs and Systems

Respiratory Bronchospasm may be a consequence of penicillin allergy. Acute severe dyspnea with cyanosis has also been observed without symptoms of bronchial obstruction or pulmonary edema. Specific mechanisms for such cases have yet to be identified. Allergic pneumonitis and transient eosinophilic pulmonary infiltrate (Loeffler’s syndrome) are rare. These syndromes have also been observed with penicillin hypersensitivity. In one case, an alveolar allergic reaction, probably due to ampicillin, showed features of an adult respiratory distress syndrome. Nervous system High doses of penicillins, in the order of several million units/day of penicillin G, can produce myoclonic jerks, hyper-reflexia, seizures, or coma. Drowsiness and hallucinations can occur occasionally. Such reactions are due to a …

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Order Zithromax Online No Prescription 250/500mg

Azithromycin: Organs and Systems Cardiovascular Torsade de pointes and cardiorespiratory arrest have been reported in a patient with congenital long QT syndrome who took azithromycin. In a prospective study of 47 previously healthy people, there was a modest statistically insignificant prolongation of the QTC interval without clinical consequences after the end of a course of azithromycin 3 g/day for 5 days. Sensory systems Ears Azithromycin can cause ototoxicity. In one study, 8 (17%) of 46 HIV-positive patients had probable (n = 6) or possible (n = 2) ototoxicity with azithromycin. The effects were hearing loss (88%), tinnitus (37%), plugged ears (37%), and vertigo (25%), developing at a mean of 7.6 weeks …

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Pulmonary Infections

Acute Pneumonias Potential Severity Acute pneumonia is a potentially life-threatening illness requiring rapid diagnosis and treatment. A delay in antibiotic treatment increases the risk of a fatal outcome. General Considerations In Acute Pneumonia Prevalence Annually, 2 to 3 million cases of pneumonia are reported in the United States. Estimates suggest that pneumonia is responsible for more than 10 million physician visits, 500,000 hospitalizations, and 45,000 deaths annually. Overall, 258 people per 100,000 population require hospitalization for pneumonia, and that number rises to 962 per 100,000 among those over the of age 65 years. It is estimated that, annually, 1 in 50 people over 65 years of age and 1 in 20 …

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Meningitis

Bacterial Meningitis Bacterial meningitis remains one of the most feared and dangerous infectious diseases that a physician can encounter. This form of meningitis constitutes a true infectious disease emergency. It is important that the physician quickly make the appropriate diagnosis and initiate antibiotic therapy. Minutes can make the difference between life and death in bacterial meningitis. The rapid progression of disease leaves no time to look through textbooks to decide on appropriate management. To assure the best outcome, every clinician needs a basic understanding of bacterial meningitis and its management. Epidemiology and Causes With the advent of the Haemophilus influenza В vaccine, the incidence of bacterial meningitis in children declined dramatically …

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Tuberculosis

Tuberculosis is a communicable infectious disease caused by Mycobacterium tuberculosis. It can produce silent, latent infection as well as progressive, active disease. Globally, 2 billion people are infected and 2 to 3 million people die from tuberculosis each year. M. tuberculosis is transmitted from person to person by coughing or sneezing. Close contacts of Tuberculosis patients are most likely to become infected. Fifty-one percent of Tuberculosis patients in the United States are foreign born, most often from Mexico, the Philippines, Vietnam, India, China, Haiti, or South Korea. In the United States, Tuberculosis disproportionately affects ethnic minorities (blacks and Hispanics). HIV is the most important risk factor for active Tuberculosis, especially among …

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Treatment of Tuberculosis

General principles Drug treatment is the cornerstone of Tuberculosis management. A minimum of two drugs, and generally three or four drugs, must be used simultaneously. Drug treatment is continued for at least 6 months and up to 2 to 3 years for some cases of multidrug-resistant Tuberculosis (MDR-Tuberculosis). Measures to assure adherence, such as directly observed therapy (DOT), are important. Pharmacologic treatment Latent Infection Chemoprophylaxis should be initiated in patients to reduce the risk of progression to active disease. Isoniazid, 300 mg daily in adults, is the primary treatment for latent Tuberculosis in the United States, generally given for 9 months. Individuals likely to be noncompliant may be treated with a …

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HIV / AIDS

Definition Table Centers for Disease Control and Prevention 1993 Revised Classification System for HIV Infection in Adults and AIDS Surveillance Case Definition and Table Centers for Disease Control and Prevention 1994 Revised Classification System for HIV Infection in Children Younger than 13 Years present the revised classification systems for adult and child HIV infection. Pathogenesis Transmission of HIV Infection with HIV occurs through three primary modes: sexual, parenteral, and perinatal. Sexual intercourse, primarily receptive anal and vaginal intercourse, is the most common vehicle for transmission. The probability of HIV transmission from receptive anorectal intercourse is 0.1% to 3% per sexual contact and 0.1% to 0.2% per sexual contact for receptive vaginal …

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