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Toxoplasma Gondii

General Considerations Epidemiology 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. In humans, the prevalence of toxoplasmosis increases with age. There are also considerable geographic differences in prevalence rates (eg, 10% in Palo Alto, CA; 15% in Boston, MA; 30% in Birmingham, AL; 70% in France; = 90% in El Salvador). Differences in the epidemiology of T […]

Toxoplasma Gondii: Treatment

Infection in Immunocompetent Adults and Children 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). Treatment should be administered for 2-4 weeks, followed by reassessment of the patient's condition. The decision to treat active toxoplasmic chorioretinitis should be based on the results of an examination performed by an ophthalmologist. Pyrimethamine and sulfadiazine plus folinic acid are commonly used for this […]

Cryptococcus Neoformans

Essentials of Diagnosis Routine laboratory tests often normal. One-third of patients are afebrile. Definitive diagnosis made by fungal culture maintained at 37°C for 6 weeks. Cryptococcal antigen 95% sensitive in CNS infection in centrifuged CSF. India ink examination positive in only 50% of meningoencephalitis cases. CSF lymphocytes often low in CNS infection, especially in AIDS patients. Cryptococcal antigen most sensitive detection method in serum. Chest radiograph variable — multiple areas of infiltration in lower lobes most common in pulmonary disease. Molecular detection by PCR might soon become laboratory standard. General Considerations Epidemiology and Ecology Cryptococcus neoformans exists as two distinct varieties known as variety neoformans and variety gattii (Table 1). Cryptococcus […]

HIV & Other Retroviruses

Essentials of Diagnosis Human immunodeficiency virus (HIV) RNA is detected and quantitated by polymerase chain reaction or branched DNA methods. Major diagnostic clues to HIV infection are a low CD4 lymphocyte count or an unexplained opportunistic infection. Human T-lymphotropic virus type 1 (HTVL-1) infection should be suspected in an adult patient with a T-cell malignancy or spastic paraparesis who is from Japan or the Caribbean basin. General Considerations Epidemiology Two major groups of retroviruses are considered in this chapter: the oncoviruses ("onco-," related to a tumor) and the lentiviruses ("lenti-," slow). Oncoviruses have long been associated with a variety of cancers in animals, including leukemia, lymphoma, and sarcoma; however, until recent […]

Order Generic Nizoral (Ketoconazole) No Prescription 200mg

Ketoconazole: Drug-Drug Interactions Aciclovir Ketoconazole seems to have a synergistic antiviral effect when it is taken with aciclovir. Alcohol A disulfiram-type reaction of ketoconazole with alcohol has been reported. Amphotericin Combination of ketoconazole with amphotericin reportedly leads to antagonism, particularly if ketoconazole therapy precedes amphotericin. Antacids Co-administration of antacids reduces the absorption of ketoconazole. Antihistamines Ketoconazole can increase the concentrations of astemi-zole and terfenadine by inhibition of CYP3A4. High concentrations of terfenadine can cause cardiac toxicity. Increased plasma concentrations of unmetabolized terfenadine prolong the QT interval and carry the risk of torsade de pointes and other fatal ventricular arrhythmias. Ebastine (10 and 20 mg/day) had no clinically important effect on QTC […]

Candidiasis Mucocutaneous

Description of Medical Condition A mucocutaneous disorder caused by infection with various species of Candida. Candida is normally present, in very small amounts, in the oral cavity, gastrointestinal tract, and female genital tract. Candida vulvovaginitis — infection on the vaginal mucosa, often associated with cutaneous vulvar involvement Orophatyngeal candidiasis — infection of the oral cavity ("thrush") and/or pharynx. Candida esophagitis — usually associated with an immunosuppressed host Gastrointestinal candidiasis — gastritis, sometimes with ulcers, usually associated with thrush. The small and large bowel can also be affected. Angular cheilitis — fissures formed by Candida infection at the corners of the mouth. System(s) affected: Skin/Exocrine, Gastrointestinal Genetics: Chronic mucocutaneous candidiasis is a […]

Anti-Infective Therapy

Despite dire warnings that we are approaching the end of the antibiotic era, the incidence of antibiotic-resistant bacteria continues to rise. The proportions of penicillin-resistant Streptococcus pneumoniae, hospital-acquired methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus strains continue to increase. Community-acquired methicillin-resistant Staphylococcus aureus is now common throughout the world. Multiresistant Acinetobacter and Pseudomonas are everyday realities in many of our hospitals. The press is now warning the lay public of the existence of "dirty hospitals." As never before, it is critical that health care providers understand the principles of proper anti-infective therapy and use anti-infective agents judiciously. These agents need to be reserved for treatable infections — not used to calm the […]

Skin and Soft Tissue Infections

Definition Bacterial infections of the skin can be classified as primary (pyodermas or cellulitis) or secondary (invasion of the wound) (Table Bacterial Classification of Important Skin and Soft Tissue Infections). Primary bacterial infections are usually caused by a single bacterial species and involve areas of generally healthy skin (e.g., impetigo, erysipelas). Secondary infections, however, develop in areas of previously damaged skin and are frequently polymicrobic in nature. The conditions that may predispose a patient to the development of skin and soft tissue infections include (1) a high concentration of bacteria, (2) excessive moisture of the skin, (3) inadequate blood supply, (4) availability of bacterial nutrients, and (5) damage to the corneal […]


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 […]

Treatment of HIV / AIDS

Goals of treatment The goal of antiretroviral therapy is to achieve the maximum suppression of HIV replication (HIV RNA level that is less than the lower limit of quantitation). Secondary goals include an increase in CD4 lymphocytes and an improved quality of life. The ultimate goal is decreased morbidity and mortality. General approach to treatment of HIV infection Regular, periodic measurement of plasma HIV RNA levels and CD4 cell counts is necessary to determine the risk of disease progression in an HIV-infected individual and to determine when to initiate or modify antiretroviral treatment regimens. Treatment decisions should be individualized by level of risk indicated by plasma HIV RNA levels and CD4 […]

Dosage forms of Zidovudine:
Retrovir iv infusion vial Retrovir 100 mg capsule Zidovudine 300 mg tablet Retrovir 300 mg tablet
Retrovir 50 mg/5ml Syrup 240ml Bottle      

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Therapeutic classes of Zidovudine:

Anti-HIV Agents, Antimetabolites, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors, Reverse Transcriptase Inhibitors


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