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173 Cholera and Other Vibrioses Treatment for shigellosis must be adapted to the clinical context, with the recognition that the most fragile patients are children <5 years, who represent two-thirds of all cases worldwide and are the group most at risk of seve...

174 Brucellosis develop hypotension, which is often apparent at admission. Cutaneous manifestations develop in most cases (usually within 36 h of onset) and characteristically involve the extremities (the lower more often than the upper). In a common sequence,...

175 Tularemia fluoroquinolone to reduce the need for valve replacement. Treat­ ment is usually given for at least 4–6 months, and clinical endpoints for its discontinuation are often difficult to define. Surgery is still required for the majority of cases of i...

176 Plague and Other Yersinia Infections type A variety. For the type B F. tularensis variety, the same surveillance data from 1964–2004 showed a 7% fatality outcome. Caution in inter­ preting these latter data is warranted, as they likely are overestimates of...

177 Bartonella Infections, Including Cat-Scratch Disease duration of therapy. On the basis of retrospective case series and in vitro sensitivity data, fluoroquinolone therapy is effective for bacteremia in adults; for example, ciprofloxacin is given at a typic...

178 Donovanosis B. henselae) and avoidance and treatment of body louse infestation (for prevention of B. quintana). Primary prophylaxis is not recommended, but suppressive therapy with a macrolide or doxycycline is indicated in HIV-infected patients with bacil...

SECTION 7 Miscellaneous Bacterial Infections TABLE 178-1  Effective Antibiotics for the Treatment of Donovanosis ANTIBIOTIC ORAL DOSE Azithromycin 1 g on day 1, then 500 mg daily for 7 days or 1 g weekly for 4 weeks Trimethoprim-sulfamethoxazole 960 mg bid for...

179 Nocardiosis TABLE 178-1  Effective Antibiotics for the Treatment of Donovanosis ANTIBIOTIC ORAL DOSE Azithromycin 1 g on day 1, then 500 mg daily for 7 days or 1 g weekly for 4 weeks Trimethoprim-sulfamethoxazole 960 mg bid for 14 days Doxycycline 100 mg b...

180 Actinomycosis Thomas A. Russo, John C. Hu Actinomycosis Actinomycosis is uncommon, and most physicians’ personal experience with its clinical presentations is limited. Laboratory identification of the etiologic agents from the order Actinomycetales is not ...

181 Whipple Disease ■ ■FURTHER READING Barberis C et al: Antimicrobial susceptibility of clinical isolates of Actinomyces and related genera reveals an unusual clindamycin resistance among Actinomyces urogenitalis strains. J Glob Antimicrob Resist 8:115, 2017....

182 Infections Due to Mixed Anaerobic Organisms Neeraj K. Surana, Dennis L. Kasper Infections Due to Mixed Anaerobic Organisms Anaerobes constitute the predominant class of bacteria of the normal human microbiota that reside on mucous membranes and predomi­ na...

SECTION 8 Mycobacterial Diseases major or sole pathogen infecting a joint, the duration of treatment should be similar to that used for arthritis caused by aerobic bacteria (Chap. 135). Although not every anaerobe needs to be covered with pathogendirected ther...

183 Tuberculosis major or sole pathogen infecting a joint, the duration of treatment should be similar to that used for arthritis caused by aerobic bacteria (Chap. 135). Although not every anaerobe needs to be covered with pathogendirected therapy in most poly...

184 Leprosy Jan H. Richardus, Hemanta K. Kar, Zoica Bakirtzief, Wim H. van Brakel Leprosy Leprosy, also referred to as Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae. The clinical manifestations are largely confined to the ski...

185 Nontuberculous Mycobacterial Infections randomized controlled trial has shown that single-dose rifampin, given once to household contacts, neighbors, and social contacts, reduces the recipients’ risk of leprosy by ~60%. Implementation studies have shown th...

186 Antimycobacterial Agents and ethambutol has been successful. Therapy is prolonged, gen­ erally continuing for 12 months after culture conversion; typically, a course lasts for at least 18 months. Other drugs with activity against MAC organisms include IV a...

SECTION 9 Spirochetal Diseases Amikacin Liposome Inhalation Suspension (ALIS)  ALIS is a new formulation of the aminoglycoside amikacin, which allows for improved penetration in the lung with reduced toxicity. In the CONVERT study, treatment with amikacin lipo...

187 Syphilis Amikacin Liposome Inhalation Suspension (ALIS)  ALIS is a new formulation of the aminoglycoside amikacin, which allows for improved penetration in the lung with reduced toxicity. In the CONVERT study, treatment with amikacin liposome inhalation su...