RESUMEN
Mycoplasma genitalium is a globally important sexually transmitted pathogen. Men infected with M. genitalium frequently present with dysuria, while women may present with or without urogenital symptoms. In some populations, M. genitalium is significantly associated with HIV-1 infection, and is also an etiological agent in pelvic inflammatory disease. However, there is insufficient evidence to establish a causative role of the organism in obstetric complications, including tubal factor infertility. Although several nucleic acid amplification tests offer rapid, sensitive methods for detecting M. genitalium, there is no standardized assay. Available evidence supports treatment of M. genitalium infections with an extended regimen of azithromycin and resistant strains respond to moxifloxacin. Accumulating evidence indicates growing fluoroquinolone resistance, including against moxifloxacin, emphasizing the need for new therapeutic strategies to treat M. genitalium infections.
Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Medicina Basada en la Evidencia , Infecciones por Mycoplasma/tratamiento farmacológico , Mycoplasma genitalium/efectos de los fármacos , Antibacterianos/farmacología , Compuestos Aza/farmacología , Compuestos Aza/uso terapéutico , Azitromicina/farmacología , Azitromicina/uso terapéutico , Femenino , Fluoroquinolonas , Humanos , Masculino , Moxifloxacino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/microbiología , Infecciones por Mycoplasma/patología , Mycoplasma genitalium/aislamiento & purificación , Quinolinas/farmacología , Quinolinas/uso terapéutico , Uretritis/diagnóstico , Uretritis/tratamiento farmacológico , Uretritis/microbiología , Uretritis/patología , Cervicitis Uterina/diagnóstico , Cervicitis Uterina/tratamiento farmacológico , Cervicitis Uterina/microbiología , Cervicitis Uterina/patologíaRESUMEN
Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) are potentially lethal plants after ingestion. Poisoning by these plants is a common toxicological emergency in tropical and subtropical parts of the world and intentional self-harm using T. peruviana is prevalent in South Asian countries, especially India and Sri Lanka. All parts of these plants are toxic, and contain a variety of cardiac glycosides including neriifolin, thevetin A, thevetin B, and oleandrin. Ingestion of either oleander results in nausea, vomiting, abdominal pain, diarrhoea, dysrhythmias, and hyperkalemia. In most cases, clinical management of poisoning by either N. oleander or T. peruviana involves administration of activated charcoal and supportive care. Digoxin specific Fab fragments are an effective treatment of acute intoxication by either species. However, where limited economic resources restrict the use of such Fab fragments, treatment of severely poisoned patients is difficult. Data from case reports and clinical studies were reviewed to identify treatments supported by evidence for the management of poisoning by N. oleander and T. peruviana.