Tags: Clindamycin

Toxoplasma Gondii

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.

Toxoplasma Gondii: Treatment

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).

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.

Pneumocystis Carinii

In 1983, P carinii pneumonia (PCP) was described as the AIDS-defining illness in = 60% of the first 1000 patients diagnosed with AIDS in the United States. Subsequently, the advent of prophylactic measures has reduced the incidence of PCP presenting as the initial diagnosis for AIDS to < 50% of cases. In addition, the hospitalization rate is also declining for patients with AIDS who also have PCP. This decline has presumably been caused by successful use of prophylaxis against the organism.

Extrapulmonary P Carinii Infections

Extrapulmonary P carinii infections occur in < 3% of patients and must be diagnosed with histopathologic samples. Primary prophylaxis for PCP with pentamidine may confer a higher risk for extrapulmonary infection. Symptoms of extrapulmonary involvement are nonspecific, usually consisting of fevers, chills, and sweats.

Mycoplasma & Ureaplasma

Mycoplasma and Ureaplasma species (mycoplasmas) are ubiquitous in nature and are commonly found in plants, animals, and humans. These bacteria contain the smallest amount of double-stranded DNA that is capable of producing a free-living microorganism; they measure between 0.15 and 0.3 um in diameter and = 2 um in length.

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.

Actinomyces

Disease occurs when mechanical insult disrupts the mucosal barrier or organisms gain access to privileged sites. For example, actinomycosis commonly occurs after dental procedures, trauma, surgery, or aspiration. Actinomyces israelii causes the majority of human disease owing to this genus, but other species, including Actinomyces naeslundii, Actinomyces viscosus, Actinomyces enksonii, Actinomyces odontolyticus, and Actinomyces meyeri have also been implicated. Actinomycosis is threefold more common in men than women.