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Nematodes

Essentials of Diagnosis Intestinal nematodes: demonstration of characteristic eggs or parasites in stool. Bloodstream nematodes (filariasis): clinical diagnosis can be made; fresh blood smear may be confirmatory. Tissue nematodes: clinical diagnosis can be made; skin snip or other tissue examination may show organism. General Considerations Nematodes (roundworms) are nonsegmented, tapered, bilaterally symmetrical, cylindrical organisms that have complete digestive tracts and reproduce sexually. Although > 500,000 species of nematodes have been described, only a small number are commonly encountered as human parasites. Most nematodes have complex life cycles, sometimes involving several larval forms and intermediate hosts or free-living stages. The pathogenic nematodes may be categorized as primarily intestinal or extraintestinal tissue parasites …

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Giardia

Essentials of Diagnosis • Key symptoms include initially profuse and watery diarrhea progressing to foul-smelling and often greasy stools that float. • It is the most common pathogen in waterborne diarrheal illness. • Patients at highest risk include infants, young children, travelers, and immunocompromised patients. • In North America, the Rocky Mountains and mountainous regions of the northwest, northeast, and British Columbia are notorious Giardia reservoirs. • Giardiasis is diagnosed either by identification of cysts or trophozoites on wet mounts of fresh stool or duodenal specimens or by antigen detection using enzyme-linked immunosorbent assay or immunofluorescence techniques. General Considerations Giardia, a genus of primitive eukaryotes, is a flagellated enteric protozoan of …

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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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Cryptosporidium, Cyclospora, & Isospora Species & Microsporidia

Within the last decade, the AIDS epidemic has heightened awareness of several gastrointestinal spore-forming protozoan pathogens. The genera Cryptosporidium, Isospora, and Cyclospora are members of the subclass Coccidia and phylum Apicomplexa; the microsporidia are a group of organisms belonging to the phylum Microspora. The spectrum of disease caused by these protozoans goes beyond gastrointestinal manifestations, and the significance of these protozoan infections is becoming increasingly appreciated in both immunocompromised and immunocompetent hosts. CRYPTOSPORIDIUM Essentials of Diagnosis • Key signs and symptoms include dehydration with watery diarrhea of variable quantity. • Waterborne transmission is the most common mode of oocyst transmission. • Patients at risk for person-to-person transmission include household contacts, sexual …

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Isospora

Essentials of Diagnosis Patients are usually either travelers to tropical areas with self-limited diarrhea or immunocompromised patients with a protracted diarrheal illness. Unsporulated oocysts are detected on wet mounts of stool samples by acid-fast staining. General Considerations A. Epidemiology. Isospora infection is endemic in several tropical and subtropical climates in areas of South America, Africa, and southwest Asia. In the United States, Isospora belli infection occurs primarily in patients with AIDS but is still quite rare in this population, accounting for = 0.2% of AIDS-defining illnesses. Isospora infection is more common in patients with AIDS from developing countries in which the prevalence of spore passage is 15% compared with 5% in …

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Cyclospora

Essentials of Diagnosis Patients present with watery diarrhea, which is usually self-limited in immunocompetent patients but may be prolonged in the immunocompromised patient. A history of travel to areas such as Nepal, Haiti, and Peru, a history of berry consumption, or community outbreak of diarrhea may increase suspicion of diagnosis. Acid-fast stain of stool specimens reveals abundant oocysts. General Considerations Cyclospora is a coccidian that had been described as a “large cryptosporidium” or “cyanobacterium-like body” before being confirmed as a member of the phylum Apicomplexa in 1993. The life cycle in humans has not been fully detailed. The organism has been shown to infect jejunal enterocytes. Similar to Isospora, the oocysts …

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Pathogenic Amebas

ENTAMOEBA HISTOLYTICA & ENTAMOEBA DISPAR Essentials of Diagnosis Patient living in or having traveled to endemic area increases risk. Frequent loose stools with blood and mucus. Demonstration of cyst or trophozoite on stool wet mount or in biopsy specimen. Serology positive within 7-10 days of infection, may remain positive for years after infection resolved. Monoclonal antibodies and polymerase chain reaction emerging; may help differentiate E histolytica and E dispar. General Considerations A. Epidemiology. There are numerous distinct species of ameba within the genus Entamoeba, and the majority of these do not cause disease in humans. E histolytica is a pathogenic species that is capable of causing disease, such as colitis or …

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Amebic Liver Abscess

Clinical Findings A. Signs and Symptoms. Amebic liver abscess is the most common extraintestinal manifestation of amebiasis. Patients may note right-upper-quadrant pain that is either dull or pleuritic in nature. Often pain is referred to the right shoulder. Less than 50% of patients have an enlarged liver. In the acute setting, patients typically manifest fever. If symptoms have been present for > 2 weeks, fever is present in less than half of patients. Respiratory symptoms, such as cough, can occur even in the absence of pulmonary disease and may be the only complaint. In the subacute setting, weight loss is common. Diarrhea is found in less than one-third of patients with …

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Chlamydia Trachomatis Infections

Essentials of Diagnosis Typical intracytoplasmic inclusions in Giemsa-stained cell scrapings from the conjunctiva. Ligase chain reaction (LCR) or polymerase chain reaction (PCR) in first-void urine. Positive culture in McCoy or HeLa cells of body fluids or secretions. Positive microimmunofluorescence serology for suspected cases of lymphogranuloma venereum and infants with pneumonia. Complement fixation titer of 1:64 or greater in patients with presumed lymphogranuloma venereum. Clinical Syndromes C trachomatis is associated with urethritis, proctitis, conjunctivitis, and arthritis in women and men; epididymitis in men; and mucopurulent cervicitis (MPC), acute salpingitis, bartholinitis, and the Fitz-Hugh and Curtis syndrome in women (Box 1). C trachomatis and Neisseria gonorrhoeae (see site) coinfections are common in women …

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Actinomyces

Essentials of Diagnosis “Sulfur granules” in specimens and sinus tract drainage: hard, irregularly shaped, yellow particles measuring from 1 to 5 mm in size Gram-positive branching filaments arranged in ray-like projections under the microscope Colonies with characteristic “molar tooth” appearance Production of extensive fibrosis with “woody” induration No specific antibody or antigen detection tests General Considerations A. Epidemiology. The Actinomyces species are facultative anaerobes that commonly inhabit the oral cavity, the gastrointestinal tract, and the female genital tract, where they exist as commensals. Diversity within this genus is broad, which has led to taxonomic revision and reclassification of some species as members of the Arcanobacterium genus, eg, Actinomyces pyogenes. Disease occurs …

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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 Metronidazole *:

Methronidazole, Metronidazol, Metronidazole Benzoate, Metronidazole Hcl, Metronidazole in Plastic Container, Metronidazolo

* 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 Metronidazole:

Name, Strength, Form, Route
Metronidazole Capsule Oral
Metronidazole Cream Intravaginal
Metronidazole Cream Topical
Metronidazole Gel Intravaginal
Metronidazole Gel Topical
Metronidazole Liquid Intravenous
Metronidazole Lotion Topical
Metronidazole Solution Intravenous
Metronidazole Tablet Oral
Metronidazole Tablet, extended release Oral

Therapeutic classes of Metronidazole:

Anti-Infective Agents, Anti-Infectives, Antiprotozoal Agents, Antiprotozoals, Radiation-Sensitizing Agents

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Common brands (equivalents) of Metronidazole, 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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