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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.

Toxoplasma Gondii

Toxoplasma gondii infection, or toxoplasmosis, is a zoonosis (the definitive hosts are members of the cat family). The two most common routes of infection in humans are by oral ingestion of the parasite and by transplacental (congenital) transmission to the fetus. Ingestion of undercooked or raw meat that contains cysts or of water or food contaminated with oocysts results in acute infection.

Toxoplasma Gondii: Treatment

Immunocompetent adults and children with toxoplasmic lymphadenitis do not require treatment unless symptoms are severe or persistent. Infections acquired by laboratory accident or transfusion of blood products are potentially more severe, and these patients should always be treated. The combination of pyrimethamine, sulfadiazine, and folinic acid for 4-6 weeks is the most commonly used and recommended drug regimen (Box 2).

Pneumocystis Carinii

In 1983, P carinii pneumonia (PCP) was described as the AIDS-defining illness in = 60% of the first 1000 patients diagnosed with AIDS in the United States. Subsequently, the advent of prophylactic measures has reduced the incidence of PCP presenting as the initial diagnosis for AIDS to < 50% of cases. In addition, the hospitalization rate is also declining for patients with AIDS who also have PCP. This decline has presumably been caused by successful use of prophylaxis against the organism.

Extrapulmonary P Carinii Infections

Extrapulmonary P carinii infections occur in < 3% of patients and must be diagnosed with histopathologic samples. Primary prophylaxis for PCP with pentamidine may confer a higher risk for extrapulmonary infection. Symptoms of extrapulmonary involvement are nonspecific, usually consisting of fevers, chills, and sweats.

Buy Lariam (Mefloquine) Without Prescription 250mg

Mefloquine, a fluorinated derivative of 4-quinoline methanol, is a product of the US Army’s antimalarial research program. It is active against chloroquine-resistant Plasmodium falciparum, and has an excellent schizonticidal effect in the blood in experimentally induced Plasmodium vivax infections in volunteers.

Fluconazole (Diflucan) Order No Prescription 50/100/150/200mg

Concurrent administration of fluconazole probably causes increased exposure to amitriptyline. Three reports of adults have shown increased amitriptyline plasma concentrations with concurrent administration of fluconazole; in one patient, a 57-year-old woman, the QT interval was prolonged and torsade de pointes occurred. In vitro studies and experiments in animals have given conflicting results relating to potential antagonism between the effects of fluconazole and amphotericin on Candida species.

Babesiosis

Several other drugs have been evaluated, including tetracycline, primaquine, sulfadiazine (Microsulfon) and pyrimethamine (Fansidar). Results have varied. Pentamidine (Pentam) has proved to be moderately effective in diminishing symptoms and decreasing parasitemia. Others: High-level parasitemia is more common in asplenic patients.

Parasitic Infections

Most infectious agents fulfill the definition of a parasite: an organism that grows, feeds, and shelters on or in a different organism and contributes nothing to the host. However, medical science has created the classification “parasite” to include a complex group of nonfungal eukaryotic human pathogens. Unlike fungi, parasites have no cell wall and are often motile.

HIV / AIDS

P. carinii pneumonia is the most common life-threatening opportunistic infection in patients with AIDS. The taxonomy of the organism is unclear, having been classified as both protozoan and fungal.

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