Resistant gram positives and use of newer antimicrobialsDino Sgarabotto
The document describes a case of a patient who developed septic shock from Methicillin-Resistant Staphylococcus epidermidis (MRSE) infection of a vascular graft, who was successfully treated with Daptomycin and Doxycycline. It then discusses resistant gram positive bacteria and newer antimicrobial options for treating such infections, noting Daptomycin and Linezolid as effective alternatives to Vancomycin in some cases.
Resistant gram positives and use of newer antimicrobialsDino Sgarabotto
The document describes a case of a patient who developed septic shock from Methicillin-Resistant Staphylococcus epidermidis (MRSE) infection of a vascular graft, who was successfully treated with Daptomycin and Doxycycline. It then discusses resistant gram positive bacteria and newer antimicrobial options for treating such infections, noting Daptomycin and Linezolid as effective alternatives to Vancomycin in some cases.
This document discusses waterborne diseases and epidemics caused by contaminated drinking water. It outlines various bacteria, viruses, and protozoa that can be transmitted through water and cause diseases like cholera, typhoid fever, diarrhea, and jaundice. Treatment of drinking water through chlorination and water filtration has reduced waterborne disease outbreaks in developed nations. However, in developing parts of the world where water treatment is not universal, waterborne illnesses remain a major public health issue. The document emphasizes the importance of access to safe drinking water and proper sanitation globally.
This document provides a list of common clinical shorthand terms used in medical documentation. It includes shorthand for examinations findings (OE, CO), medical history (PH, FH, SH, HPC), routes of medication administration (IV, IM, SC), common conditions (PUO, URTI, CA, CCF), procedures (POP), vital signs (BP), anatomical locations (PR, PV), medication frequencies (OD, BD, TID, QID), relevance indicators (NR, NAD), notation for levels/amounts (-, ±, +, ++, +++, ++++), time periods (5/7, 3/7, 2/52, 1/52, 2/12, 3/12
How to manage malaria in a outpatient clinic in ethiopiaDino Sgarabotto
This document provides guidance on managing malaria in an outpatient clinic in Ethiopia. It describes the different Plasmodium species that cause malaria, with P. falciparum being the most severe and life-threatening. For uncomplicated P. falciparum malaria, the first-line treatment is artemether + lumefantrine taken twice daily for 3 days. For severe or complicated cases, the treatment is intravenous quinine followed by a complete oral course of artemether + lumefantrine once the patient has improved. P. vivax is generally not life-threatening but should be treated with chloroquine, followed by primaquine to prevent relapse. Proper diagnosis, treatment, and
Standard treatment guideline for primary hospital in ethiopia 2010Dino Sgarabotto
Faculty of Medicine, AAU, Internist
23. Kassahun Kiros, Dr.
-
Black Lion Hospital, Gynecologist
24. Kassu Desta, Dr.
-
Minilik II Hospital, Internist
25. Kebede Deribe, Dr.
-
Addis Ababa Health Bureau, GP
26. Kebede Gebre, Dr.
-
Minilik II Hospital, Internist
27. Kebede Tadesse, Dr.
-
Minilik II Hospital, Internist
28. Kefyalew Addis, Dr.
This document describes a case study of a lung transplant patient who developed invasive aspergillosis involving the brain, lungs, and mitral valve. The patient was initially treated with caspofungin and voriconazole. Several years later, the patient presented with a prostatic abscess caused by Aspergillus. Treatment with voriconazole and caspofungin was ineffective. Switching to liposomal amphotericin B resulted in fever disappearance and culture negative samples. The patient later underwent surgical removal of the aspergilloma. This case highlights the risk of invasive aspergillosis in lung transplant patients and questions the optimal treatment and secondary prophylaxis.
PPT Matteelli ""The infectious disease physician and the diagnosis of tubercu...StopTb Italia
PPT Matteelli "The infectious disease physician and the diagnosis of tuberculosis", Symposium on TB, 14 October, III Session (physicians & surgeons), Monza, Italy.
This document discusses waterborne diseases and epidemics caused by contaminated drinking water. It outlines various bacteria, viruses, and protozoa that can be transmitted through water and cause diseases like cholera, typhoid fever, diarrhea, and jaundice. Treatment of drinking water through chlorination and water filtration has reduced waterborne disease outbreaks in developed nations. However, in developing parts of the world where water treatment is not universal, waterborne illnesses remain a major public health issue. The document emphasizes the importance of access to safe drinking water and proper sanitation globally.
This document provides a list of common clinical shorthand terms used in medical documentation. It includes shorthand for examinations findings (OE, CO), medical history (PH, FH, SH, HPC), routes of medication administration (IV, IM, SC), common conditions (PUO, URTI, CA, CCF), procedures (POP), vital signs (BP), anatomical locations (PR, PV), medication frequencies (OD, BD, TID, QID), relevance indicators (NR, NAD), notation for levels/amounts (-, ±, +, ++, +++, ++++), time periods (5/7, 3/7, 2/52, 1/52, 2/12, 3/12
How to manage malaria in a outpatient clinic in ethiopiaDino Sgarabotto
This document provides guidance on managing malaria in an outpatient clinic in Ethiopia. It describes the different Plasmodium species that cause malaria, with P. falciparum being the most severe and life-threatening. For uncomplicated P. falciparum malaria, the first-line treatment is artemether + lumefantrine taken twice daily for 3 days. For severe or complicated cases, the treatment is intravenous quinine followed by a complete oral course of artemether + lumefantrine once the patient has improved. P. vivax is generally not life-threatening but should be treated with chloroquine, followed by primaquine to prevent relapse. Proper diagnosis, treatment, and
Standard treatment guideline for primary hospital in ethiopia 2010Dino Sgarabotto
Faculty of Medicine, AAU, Internist
23. Kassahun Kiros, Dr.
-
Black Lion Hospital, Gynecologist
24. Kassu Desta, Dr.
-
Minilik II Hospital, Internist
25. Kebede Deribe, Dr.
-
Addis Ababa Health Bureau, GP
26. Kebede Gebre, Dr.
-
Minilik II Hospital, Internist
27. Kebede Tadesse, Dr.
-
Minilik II Hospital, Internist
28. Kefyalew Addis, Dr.
This document describes a case study of a lung transplant patient who developed invasive aspergillosis involving the brain, lungs, and mitral valve. The patient was initially treated with caspofungin and voriconazole. Several years later, the patient presented with a prostatic abscess caused by Aspergillus. Treatment with voriconazole and caspofungin was ineffective. Switching to liposomal amphotericin B resulted in fever disappearance and culture negative samples. The patient later underwent surgical removal of the aspergilloma. This case highlights the risk of invasive aspergillosis in lung transplant patients and questions the optimal treatment and secondary prophylaxis.
PPT Matteelli ""The infectious disease physician and the diagnosis of tubercu...StopTb Italia
PPT Matteelli "The infectious disease physician and the diagnosis of tuberculosis", Symposium on TB, 14 October, III Session (physicians & surgeons), Monza, Italy.
Valganciclovir is a prodrug of ganciclovir used for CMV prophylaxis and treatment. A key study (PV16000) found that valganciclovir prophylaxis for 100 days was as effective as oral ganciclovir for preventing CMV disease in high-risk transplant patients. Valganciclovir had a higher bioavailability than oral ganciclovir but was associated with a higher rate of neutropenia as an adverse effect. Long-term follow up of patients in the VICTOR study found rates of CMV disease recurrence after stopping prophylaxis of 15.1% at 1 year. Factors like viral load at baseline and
This document summarizes important viral pathogens affecting solid organ transplant recipients. It discusses several common viruses like CMV, HHV-6, EBV, adenovirus, and BKV polyomavirus. It notes their clinical manifestations and impacts in transplant recipients. The document also reviews prevention and treatment strategies for many of these viruses, including vaccination, antiviral prophylaxis, and immunosuppression management. Meta-analyses show antiviral prophylaxis is effective at preventing CMV infection and disease, and may reduce indirect effects like other infections and rejection.
Bisogni fisici degli immigrati ed accesso alle cure
Amebiasi
1. Amebiasi
Dr. Dino Sgarabotto
Malattie Infettive e Tropicali
Azienda Ospedaliera di Padova
2. EPIDEMIOLOGIA
La terza più diffusa infezione parassitaria
(dopo malaria e schistosomiasi)
circa 480 Milioni di persone nel mondo
prevalentemente nelle regioni tropicali
gruppi ad alto rischio: viaggiatori, immigrati,
immunodepressi, donne gravide, prigioni
Portatori asintomatici di cisti
Possibile trasmissione sessuali (per via anale)
8. Specie patogene e non patogene
• Alcune specie invasive e non invasive sono
morfologicamente identici ma appartengono
a due specie diverse:
– Ceppo Invasivo – E.histolytica
– Ceppo non invasivo riclassificato come E.dispar
• Specie non patogene: Entamoeba coli, Entamoeba
hartmanni, Endolimax nana, Iodamoeba buyschlii e
Chilomastix mesnili
• Specie scarsamente patogene: Dientamoeba
fragilis (solo sintomi intestinali e non
extraintestinali)
9. Fattori predisponenti
Fattori che contribuiscono alla gravità della
malattia:
1 Malnutrizione
2 Alcoolismo
3 Terapia corticosteriodea
4 Immunodeficienza
5 Alterazione della flora batterica
11. Sensitivity and specificity of different
laboratory tests for diagnosis of amebiasis
Sensitivity (%)
Specificity
Specimen Liver Time Cost
Colitis (%)
abscess
Stool 25–60% < 10% 10–50%
Microscopy Liver
1–2 h Low
(wet mount/ abscess
permanent stain) NA < 25% 100%
fluid
Usually
Stool > 95% > 95%
negative
75% (late),
Antigen Serum 65% (early) 100% (early > 90%
detection, before
detection Treatment)
3h Low
(ELISA)
Liver abscess
100% (before
Fluid NA Treatment) 90-100%
12. Sensitivity and specificity of different
laboratory tests for diagnosis of amebiasis
Sensitivity (%)
Specificity
Specimen Liver Time Cost
Colitis (%)
abscess
Serum
(acute 75–85 70–100 > 85
infection)
Antibody
2–3 h Low
detection Serum
(convalescent
infection)
> 90 > 90 yes
Stool > 90% NA > 90%
PCR-
based 1-2 days High
Liver abscess
assays Fluid NA 100 90–100
13. Terapia dell’amebiasi
Sono usati frequentemente per trattare l’amebiasi o il
Metronidazole (Flagil) or Tinidazole (Fasigin).
Altrimenti si possono usare la Clorochina, Emetina e
Diidroemetina.
L’eliminazione delle cisti dai portatori asintomatici si
può fare con Diloxanide furoate
(Furamide), Iodochinolo (Yodoxin), and
Paromomicina (Humatin). Infine il Nitazoxanide
(Nizonide) c’è un nuovo farmaco antiparassitario ad
ampio spettro per le parassitosi intestinali
14. Presentazione Farmaco Dosaggio per adulti
clinica
Portatore 1° scelta
intestinale Diloxanide Furoate 500 mg TID 10 giorni
asintomatico
2° scelta
Paramomicina 25 – 30 mg/kg/die in 3
(o) dosi 7-10 giorni
Iodochinolo 650 mg TID 20 giorni
1° scelta
Metronidazolo seguito 750 mg TID 10 giorni
Infezione da
diloxanide furoate
intestinale 500 mg TID 10 giorni
(o)
Tinidazolo 2 g/die 2-3 giorni
seguito da
diloxanide furoate 500 mg TID 10 giorni
2° scelta 25 – 30 mg/kg/die in 3
Paramomicina dosi 7-10 giorni
15. Ameabiasi epatica
• Gli unici farmaci disponibili sono:
– Metronidazolo 750 mg TID per 10 giorni
– Clorochina 600 mg (4 compresse) al giorno per 2
giorni, seguita da 300 mg (2 compresse) al giorno per 14-
28 giorni
• Non più disponibili invece:
– Emetina 65 mg al dì intramuscolo per 10 giorni
– Diidroemetina (meno cardiotossica) 80 mg al dì
intramuscolo per 10 giorni
16. Bibliografia
• Haque R, Huston CD, Hughes M,Houpt E, and Petri WA Jr:
Amebiasis. N Engl J Med 2003, 348:1565-1573
• Pritt BS, Clack CG: Amebiasis. Mayo Clin Proc 2008, 83(10):
1154-60
• Fotedar R, Stark D, Beebe N, Marriott D, Ellis J and Harkness
J: Laboratory Diagnostic Techniques for Species Entamoeba.
Clin. Microbiol. Rev. 2007, 20(3): 511-532
Grazie per
l’attenzione!!
