Tags: Psittacosis

Chlamydia Psittaci Infections

Pneumonia, pericarditis, myocarditis, and endocarditis have been attributed to C psittaci infection (psittacosis or ornithosis) (Box 5). The incubation period for the pneumonia is usually 1-2 weeks. Its onset is gradual with body temperature increasing over a period of 5-7 days; however, there are cases in which the onset is sudden with rigors and temperatures as high as 104 °F.

Chlamydia Pneumoniae

Chlamydia pneumoniae an obligate intracellular bacteria, has been established as an important cause of adult respiratory disease including pneumonia, bronchitis, sinusitis and pharyngitis. There is no animal reservoir. Incidence/Prevalence in USA: Estimated incidence of 100 to 200 cases of pneumonia/100,000/ year.

Brucellosis

Systemic bacterial infection caused by Brucella species in infected animal products, or vaccine. Incubation period usually 5-60 days, but highly variable and may be several months.

Specific Anti-Infective Agents

Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in each class can be subtle, often requiring the expertise of an infectious disease specialist to design the optimal anti-infective regimen. The general internist or physician-in-training should not attempt to memorize all the facts outlined here, but rather should read the pages that follow as an overview of anti-infectives. The chemistry, mechanisms of action, major toxicities, spectrum of activity, treatment indications, pharmacokinetics, dosing regimens, and cost are reviewed.

Epidemiologic and virulence factors in infectious diseases

Before appropriate therapy can be given for an infectious disease, consideration of epidemiologic factors is essential. This section does not fully discuss the epidemiology (the determinants, occurrence, distribution, and control of health and disease) of infectious diseases. However, a number of basic principles and historical points are worth emphasizing.

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Doxycycline calcium, doxycycline hyclate, and doxycycline monohydrate are administered orally. When oral therapy is not feasible, doxycycline hyclate may be administered by slow IV infusion; however, oral therapy should replace IV therapy as soon as possible.

Tetracyclines General Statement: Uses

Tetracyclines are used principally in the treatment of infections caused by susceptible Rickettsia, Chlamydia, Mycoplasma, and a variety of uncommon gram-negative and gram-positive bacteria.

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Prior to initiation of erythromycin therapy, appropriate specimens should be obtained for identification of the causative organism and in vitro susceptibility tests. Use of erythromycin does not preclude the necessity for surgical procedures (such as incision and drainage) as needed. There does not appear to be a difference in clinical efficacy among the erythromycin derivatives when each is administered in appropriate doses. However, some clinicians believe that the risk of hepatotoxicity from the estolate derivative does not justify its use.

Chlamydial sexually transmitted diseases

An obligate intracellular membrane-bound prokaryotic organism, chlamydia trachomatis causes an estimated 3 million new sexually transmitted infections in the US each year. The estimated cost of chlamydia STDs in 1994 was $2 billion per year in the U. S., largely due to costly complications such as PID, infertility, and ectopic pregnancy. Studies indicate that 75-90% of women and 50-90% of men with chlamydial STD are asymptomatic.

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Erythromycin is a macrolide antibacterial with a wide spectrum of activity, that has been used in the treatment of a wide range of infections caused by susceptible organisms.