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Infectious and parasitic causes of hypopigmentation
Published in Electra Nicolaidou, Clio Dessinioti, Andreas D. Katsambas, Hypopigmentation, 2019
Serena Gianfaldoni, Aleksandra Vojvodic, Nooshin Bagherani, Bruce R. Smoller, Balachandra Ankad, Leon Gilad, Arieh Ingber, Fabrizio Guarneri, Uwe Wollina, Torello Lotti
For the treatment of yaws, the WHO recommends a single oral dose of azithromycin (30 mg/kg, with a maximum of 2 g). Benzathine penicillin as a single intramuscular dose of 1.2 million units (MU) of BPG for people aged over 10 years, and 0.6 MU for children less than 10 years of age, for those patients who “clinically fail on azythromycin” or are allergic to azithromycin.60
Gastrointestinal and liver infections
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Infection with Treponema pallidum continues to be a common cause of anorectal ulceration. The chancre usually occurs within 21 days of infection and heals spontaneously within 3-6 weeks. As an early form of syphilis, this should be treated with benzathine penicillin G 2.4 million units orally as a single dose. Alternative regimens include aqueous procaine penicillin 600 000-900 000 units intramuscular daily for 10 days, tetracycline 500 mg four times daily orally for 15 days and doxycycline 100 mg twice daily orally for 15 days. The treatment for Mycobacterium tuberculosis (see p. 121), HSV and CMV (see p. 113) and schistosomal infections (Table 6.9) are described elsewhere in this chapter.
Sexually Transmitted Diseases
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Lester Gottesman, Christina Cellini
Penicillin G, administered parenterally, is the preferred drug for treating persons in all stages of syphilis. The preparation used (i.e. benzathine, aqueous procaine or aqueous crystalline), dosage and length of treatment depend on the stage and clinical manifestations of the disease. For early syphilis, benzathine penicillin G 2.4 million units administered intramuscularly in a single dose is the recommended treatment. Stage and clinical presentation further determine the preparation, dosage and length of treatment. Additional medications, such as azithromycin and ceftriaxone, may have a role in management.26 The management of tertiary syphilis, pregnant women with syphilis and congenital syphilis is beyond the scope of this chapter. More information on syphilis in these settings, as well as treatment recommendations, can be obtained from the CDC Morbidity and Mortality Weekly Report.2 There is no strong evidence to support prolonged or augmented therapy in treating syphilis in patients who are HIV positive.1,27
Epithelial dysfunction, respiratory infections and asthma: the importance of immunomodulation. A focus on OM-85
Published in Expert Review of Respiratory Medicine, 2020
Fabio Cardinale, Enrico Lombardi, Oliviero Rossi, Diego Bagnasco, Aldo Bellocchi, Francesco Menzella
Children with recurrent RTIs commonly are not affected by immune defects and these infections may simply represent increased exposure to infectious agents during the first years of life, when immune function is still immature [19]. However, children with selective antibody deficiency may be at higher risk for recurrent infection [20]. In 87 children with IgA and IgG subclass deficiencies, 76% presented with recurrent upper RTIs. A number of 68 (78%) of patients received prophylactic treatment with benzathine penicillin, prophylactic oral antibiotic, or oral bacterial extract and these patients suffered 2.5 ± 2.3 infections/year compared to 7.9 ± 4.9 infections/year in children without any prophylactic regimen [21]. This decrease in frequency did not show any significant difference between different prophylactic groups. Serum IgA recovered to normal range in 52% of children with partial IgA deficiency and serum IgG recovered to of normal range in 67% of children with IgG plus IgA subclass deficit and 30% of children with isolated subclass deficits.
Alopecia syphilitica, from diagnosis to treatment
Published in Baylor University Medical Center Proceedings, 2022
Mojahed Mohammad K. Shalabi, Brooke Burgess, Samiya Khan, Eric Ehrsam, Amor Khachemoune
After treatment, hair regrowth on the scalp can be expected between 5 and 12 weeks after administration.4 Clinical monitoring 6 and 12 months after treatment is necessary. However, for HIV patients with AS, monitoring should be more frequent at 3, 6, 9, 12, and 24 months after therapy due to the increased risk of treatment failure in this group. Nontreponemal tests such as VDRL can be used to monitor titers after treatment and should be compared with titers on the day of treatment. If the titer has not decreased over fourfold, then retreatment, serology, and follow-up should be considered. Retreatment for all patients includes weekly injections of benzathine penicillin G 2.4 million units for 3 weeks.15
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
Under antibiotic therapy, there was an improvement of the general health and shrinkage of the neck swelling. However, the uveitis regressed very slowly, and the patient stayed in follow-up for that. During the proposed 14-day treatment with IV benzathine penicillin G, the patient missed 8 administrations. Due to therapy incompliance, we extended the duration of the antibiotic therapy by 2 days. Her sexual partner and 5-month-old daughter were also screened for syphilis. Her partner tested positive and was treated with two intramuscular injections of 1.2 million units of benzathine-penicillin. Her 5-month-old daughter tested negative.