Tags: Pyrazinamide

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. …

Continue Reading...

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 …

Continue Reading...

Tuberculosis: Clinical Syndromes

PULMONARY TUBERCULOSIS The most common syndrome in adults is pulmonary TB, which accounts for ~ 80% of cases of active disease. Clinical Findings A. Signs and Symptoms. Symptoms of infection consist of fatigue, weight loss, fever, night sweats, and a productive cough. Most children who are infected with TB usually have no symptoms. Early symptoms can also include hemoptysis, which also occurs later in the disease when there is significant necrosis of lung parenchyma or if previous cavitations erode into arterioles. Patients with subpleural parenchymal inflammation with pleural membrane involvement or with TB pleuritis without parenchymal disease can experience pleuritic chest pain. Severe shortness of breath is not common. However, extensive …

Continue Reading...

Buy Generic Levaquin (Levofloxacin) No Prescription 250/500/750mg

Levofloxacin: Side Effects See also Fluoroquinolones Levofloxacin, the levorotatory (S)-enantiomer of the racemate ofloxacin, is an oral and parenteral fluoroquinolone that has bactericidal activity against a wide spectrum of Gram-negative and Gram-positive bacilli (including Streptococcus pneumoniae), as well as atypical respiratory pathogens. In patients with meningitis, levofloxacin penetration in cerebrospinal fluid and the liquor-to-plasma ratio was assessed at 2 hours after dosing in five patients with spontaneous acute bacterial meningitis. Cerebrospinal fluid levofloxacin concentration at 2 hours after dosing was 2.0 µg/ml, and the liquor-to-plasma ratio at 2 hours after dosing was 0.35. Observational studies In 10 patients who took levofloxacin 500 mg/day and rifampicin 600 mg/day for 2-6 months, there …

Continue Reading...

Buy Cheap Levaquin (Levofloxacin) Without Prescription 250/500/750mg

Levofloxacin: Organs and Systems Cardiovascular Preclinical and clinical trial data and data from phase IV studies have suggested that levofloxacin causes prolongation of the QT interval. There were cardiovascular problems in 1 in 15 million prescriptions compared with 1-3% of patients taking sparfloxacin, who had QTC prolongation to over 500 ms. Polymorphous ventricular tachycardia with a normal QT interval has been associated with oral levofloxacin in the absence of other causes. Among 23 patients who took levofloxacin 500 mg/day there was prolongation of the QTC interval by more than 30 ms in four patients and 60 ms in two patients. There was absolute QT interval prolongation to over 500 ms in …

Continue Reading...

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 …

Continue Reading...

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 …

Continue Reading...

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 …

Continue Reading...

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 …

Continue Reading...

Central Nervous System Infections

Definition Central nervous system infections include a wide variety of clinical conditions and etiologies: meningitis, meningoencephalitis, encephalitis, brain and meningeal abscesses, and shunt infections. The focus of this chapter is meningitis. Pathophysiology Infections are the result of hematogenous spread from a primary infection site, seeding from a parameningeal focus, reactivation from a latent site, trauma, or congenital defects in the central nervous system. central nervous system infections may be caused by a variety of bacteria, fungi, viruses, and parasites. The most common causes of bacterial meningitis include Streptococcus pneumoniae, Neisseria meningitides, Listeria monocytogenes, and Haemophilus influenzae. The critical first step in the acquisition of acute bacterial meningitis is nasopharyngeal colonization of …

Continue Reading...
CLOSE
CLOSE