14 November 2010

Jarisch-Herxheimer Reaction

Jarisch-Herxheimer Reaction Facts:
  • Is a reaction due to bacterial endotoxins & microbial antigens which are liberated by microorganisms following their destruction.
  • The reaction is not an indication to stop treatment because symptoms resolve with continued therapy.
Clinical Features:
  • General - fever
  • Skin - transient macular or urticarial eruptions, & exacerbation of preexisting skin lesions.
  • Immune - tender lymphadenopathy
  • Rheumatological - arthralgias
Aetiological Factors:
  • Diethylcarbamazine therapy for oncocerciasis.
  • Penicillin therapy for syphilis.
  • Griseofulvin therapy for dermatophyte infections.
  • Ketoconazole therapy for dermatophyte infections.
Tags: Dermatophyte Infection - Diethylcarbamazine - Endotoxin - Griseofulvin - Jarisch-Herxheimer Reaction - Ketoconazole - Onchocerciasis - Penicillin - Syphilis
Posted by Medicalchemy
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16 October 2010

Campylobacter Enteritis Antibiotic Treatment

Campylobacter Enteritis General Comments:
  • Role of antibiotics is controversial.
  • Erythromycin can rapidly eliminate Campylobacter from the stool.
  • Erythromycin has not been shown to affect the duration of illness.
  • Campylobacter jejuni dysentry in children, may show benefit from early treatment with erythromycin.
  • In children, avoid tetracyclines & quinolones.
Public Health Issues:
  • Multiple antibiotic resistance may be seen in Campylobacter acquired from animals because of the widespread use of antibiotics in animals.
  • Quinolone use has also been withdrawn from commercial poulty farming in the USA because of rising ciprofloxacin resistance.
Indications For Antibiotics:
  • Bloody diarrhoea
  • High fever
  • Illness lasting for over a week
  • Immunocompromise
  • More than 8 stools daily
  • Pregnancy
  • Worsening clinical condition
Antibiotics Useful:
  • Azithromycin
  • Erythromycin
  • Quinolones
References:
  • Nelson JM, Chiller TM, Powers JH, et al. Fluoroquinolone-resistant Campylobacter species and the withdrawal of fluoroquinolones from use in poultry: a public health success story. Clin Infect Dis. 2007 Apr 1;44(7):977-80. Epub 2007 Feb 14. [abstract]
  • Shea KM. Nontherapeutic use of antimicrobial agents in animal agriculture: implications for pediatrics. Pediatrics. 2004 Sep;114(3):862-8. [abstract]

Tags: Antibiotics - Azithromycin - Campylobacter - Campylobacter enteritis - Erythromycin - Poultry
Posted by Medicalchemy
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10 October 2010

Systemic Inflammatory Response Syndrome (SIRS)

SIRS criteria met if 2 or more of following signs are present:
  • Temperature > 38°C (100.4°F) or < 36°C (96.8°F).
  • Pulse > 90 beats/min.
  • Respiratory Rate (RR) > 20 breaths/min (or partial pressure of carbon dioxide in arterial blood [PaCO2] <>
  • White blood cell count (WBC) > 12,000/mm3 or <> 10% immature bands).

Source: Consensus Conference of the American College of Chest Physicians and Society of Critical Care Medicine
Tags:
Fever - Leukocytosis - Leukopaenia -
SIRS - Tachypnoea
Posted by Medicalchemy
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18 September 2010

Medicalchemy Infection Blog

This Medicalchemy (TM) blog will be about Infection related topics.

Tags: Blog - Infection
Posted by Medicalchemy
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