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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.

Non-falciparum Malaria (P Vivax, P Ovale, P Malariae)

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.

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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.

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A 7-day quinine regimen (10 mg/kg salt, 8-hourly for 7 days) has been compared with oral mefloquine 25 mg/kg plus artesunate 4 mg/kg/day for 3 days in 108 women on the Thai-Burmese border. The mefloquine plus artesunate regimen was significantly more effective than quinine (day 63, cure rate 98 versus 67%). There were more episodes of dizziness (RR = 1.93; 95% CI = 1.14) and tinnitus (RR = 3.93; 95% CI = 1.98) with quinine, but no serious adverse events were attributable to either drug.

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.

Management of Sepsis

Sepsis, sepsis syndrome, septic shock, and multiorgan dysfunction are all part of a continuum of infection-related systemic illness. Table Definitions for Sepsis, Sepsis Syndrome, Septic Shock and Multiorgan Dysfunction Syndrome gives definitions for each of these entities. The pathogenesis of sepsis is very complex, involving a large number of mediators.

Dosage forms of Mefloquine:
Mefloquine hcl 250 mg tablet Lariam 250 mg tablet Lariam 25 250 mg tablet Box

Synonyms of Mefloquine:

Mefloquine HCL, Mefloquinone

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Therapeutic classes of Mefloquine:

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