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Actinomycetes

Originally thought to be fungi due to their hyphae-like appearance, they are now recognized as bacteria based on their cell wall components, reproduction by fission without sporulation or budding, inhibition by antibacterial agents, and molecular phylogenetic analysis. The actinomycete chromosomes contain a high content of guanosine and cytosine.

Nocardia

Nocardia spp. are strictly aerobic, ubiquitous soil-dwelling organisms that are largely responsible for the decomposition of organic plant material. Infection usually occurs via inhalation of these organisms in airborne dust particles, leading to pulmonary disease.

Haemophilus, Bordetella, & Branhamella Species

Before 1990, strains of Haemophilus influenzae type b were found in the upper respiratory tract of 3-5% of children and a small percentage of adults. Colonization rates with type-b strains are even lower now, reflecting routine immunization of infants against H influenzae type b. Non-type-b encapsulated H influenzae are present in the nasopharynx of < 2% of individuals, whereas nonencapsulated (nontypable [see below]) strains colonize the respiratory tract of 40-80% of children and adults.

Branhamella Catarrhalis: Clinical Syndromes

B catarrhalis causes bronchitis and pneumonia in patients with underlying lung disease, especially chronic obstructive pulmonary disease. It is also a rare cause of invasive disease, including meningitis, endocarditis, bacteremia without a focus, septic arthritis, and cellulitis.

Haemophilus Influenzae: Clinical Syndromes

H influenzae was first isolated during the 1892 influenza pandemic and was originally believed to be the causative agent of influenza. Although subsequent studies revealed the fallacy of this idea, H influenzae has proved to be a common cause of localized respiratory tract and systemic disease, including meningitis, epiglottitis, pneumonia, pyogenic arthritis, cellulitis, otitis media, and sinusitis, among others (Box 1). Meningitis is the most common and serious form of invasive H influenzae type-b disease. In the mid-1980s, before the introduction of effective vaccines, ~ 10,000-12,000 cases of H influenzae type-b meningitis occurred in the United States each year, and 95% of cases involved children < 5 years old.

Other Pseudomonas Species of Medical Importance

This organism is endemic in Southeast Asia with the highest prevalence in Thailand. The organism is a saprophyte living in the soil. Infection may be subclinical, acute, subacute, or chronic.

Enterococci: Clinical Syndromes

Urinary tract infections, including uncomplicated cystitis, pyelonephritis, prostatitis, and perinephric abscess, are the most common type of clinical infections produced by enterococci (Box 1). Most enterococcal urinary tract infections are nosocomial and are associated with urinary catheterization or instrumentation. Nosocomial enterococcal bacteremias are commonly polymicrobial. Portals of entry for enterococcal bacteremia include the urinary tract, intra-abdominal or pelvic sources, wounds (especially burns, decubitus ulcers, and diabetic foot infections), intravascular catheters, and the biliary tree.

Streptococcal Toxic Shock Syndrome

In the late 1980s, invasive GAS infections occurred in North America and Europe in previously healthy individuals of all ages. This illness is associated with bacteremia, deep soft-tissue infection, shock, multi-organ failure, and death in 30% of cases. StrepTSS occurs sporadically, although minor epidemics have been reported. Most patients present with a viral-like prodrome, history of minor trauma, recent surgery, or varicella infection.

Order Amoxil (Amoxicillin) Without Prescription 500mg

Amoxicillin, an acid stable, semi-synthetic drug belongs to a class of antibiotics called the Penicillins (beta-lactam antibiotics). It is shown to be effective against a wide range of infections caused by wide range of Gram-positive and Gram-negative bacteria in both human and animals.

Order Zithromax Online No Prescription 250/500mg

Torsade de pointes and cardiorespiratory arrest have been reported in a patient with congenital long QT syndrome who took azithromycin. In a prospective study of 47 previously healthy people, there was a modest statistically insignificant prolongation of the QTC interval without clinical consequences after the end of a course of azithromycin 3 g/day for 5 days. Azithromycin can cause ototoxicity. In one study, 8 (17%) of 46 HIV-positive patients had probable (n = 6) or possible (n = 2) ototoxicity with azithromycin.