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188 Endemic Treponematoses Rates of decline of serologic titers appear to be slower, and serologi­ cally defined treatment failures more common among HIV-infected patients than among those without HIV co-infection; however, effective ART may reduce these diffe...

189 Leptospirosis A B FIGURE 188-3  Clinical manifestations of bejel and pinta. A. Mucous patches of early bejel. B. Pigmented macules of early pinta. (Photos reprinted with permission from the Handbook of Endemic Treponematoses, PL Perine et al, Geneva, World...

190 Relapsing Fever TABLE 189-1  Treatment and Chemoprophylaxis of Leptospirosis in Adultsa INDICATION REGIMEN Treatment Mild leptospirosis Doxycyclineb (100 mg PO bid) or Amoxicillin (500 mg PO tid) or Ampicillin (500 mg PO tid) Moderate/severe leptospirosis ...

191 Lyme Borreliosis There are shortcomings of single-dose therapies for LBRF. With penicillin alone, recurrence may occur in up to 20% of patients, and the frequency of JHR was higher after tetracycline than penicillin. For treatment of LBRF in adults in Ethi...

SECTION 10 Diseases Caused by Rickettsiae, Mycoplasmas, and Chlamydiae ■ ■FURTHER READING Arvikar SL, Steere AC: Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am 36:563, 2022. Aucott JN: Posttreatment Lyme disease syndrome. Infect Dis Clin N...

192 Rickettsial Diseases ■ ■FURTHER READING Arvikar SL, Steere AC: Diagnosis and treatment of Lyme arthritis. Infect Dis Clin North Am 36:563, 2022. Aucott JN: Posttreatment Lyme disease syndrome. Infect Dis Clin North Am 29:309, 2015. Branda JA, Steere AC: La...

193 Infections Due to Mycoplasmas rifampin. Although antimicrobial susceptibility testing is not rou­ tinely performed and resistance to doxycycline does not appear to be a common problem in clinical practice, doxycycline-resistant isolates do exist. Treatment...

194 Chlamydial Infections urogenital tract. The vagina yields the largest number of organisms; next most densely colonized are the periurethral area and the cervix. Ureaplasmas are isolated less often from urine than from the cervix, but M. hominis is found wi...

SECTION 11 Viral Diseases: General Considerations as they are not specific for C. pneumoniae but identify the chlamydiae only to the genus level. TREATMENT C. pneumoniae Infections Although few controlled trials of treatment have been reported, C. pneumoniae i...

195 Principles of Medical Virology as they are not specific for C. pneumoniae but identify the chlamydiae only to the genus level. TREATMENT C. pneumoniae Infections Although few controlled trials of treatment have been reported, C. pneumoniae is inhibited in ...

196 Antiviral Chemotherapy, Excluding Antiretroviral Drugs following the real infection pathway. In addition, clinical preparations of viruses used for vaccines, vaccine vectors, gene therapy vectors, and oncolytic viruses need to be defined precisely and spec...

SECTION 12 Infections Due to DNA Viruses (CAPSTONE-2): A randomised, placebo-controlled, phase 3 trial. Lancet Infect Dis 20:1204, 2020. Saullo JL, Miller RA: Cytomegalovirus therapy: Role of letermovir in prophylaxis and treatment in transplant recipients. An...

197 Herpes Simplex Virus Infections (CAPSTONE-2): A randomised, placebo-controlled, phase 3 trial. Lancet Infect Dis 20:1204, 2020. Saullo JL, Miller RA: Cytomegalovirus therapy: Role of letermovir in prophylaxis and treatment in transplant recipients. Annu Re...

198 Varicella-Zoster Virus Infections effective in the developing world, their clinical and virologic ben­ efits, especially in reducing the frequency of genital lesions among patients in Africa, seem reduced from those in European and U.S. populations. The me...

199 Epstein-Barr Virus Infections, Including Infectious Mononucleosis TABLE 198-1  Recommendations for VZIG Administration Exposure Criteria Significant exposure to a person with chickenpox or zoster a. Household: residence in the same household b. Playmat...

200 Cytomegalovirus and Human Herpesvirus Types 6, 7, and 8 TREATMENT EBV-Associated Disease Therapy for IM consists of supportive measures, with rest and analgesia. Excessive physical activity during the first month should be avoided to reduce the possibility...

201 Monkeypox, Molluscum Contagiosum, and Other Poxvirus Infections Primary HHV-8 infection in immunocompetent children may manifest as fever and maculopapular rash. Among individuals with intact immunity, chronic asymptomatic infection is the rule, and neo­ p...

202 Parvovirus Infections (e.g., research laboratorians) to orthopoxviruses via either ACAM2000 or JYNNEOS. Booster doses for these persons at sustained risk for occupational exposure to orthopoxviruses should be administered either 2 years, 3 years, or 10 yea...