RESUMO
Influenza is an acute viral respiratory infection that causes significant morbidity and mortality worldwide. Three types of influenza cause disease in humans. Influenza A is the type most responsible for causing pandemics because of its high susceptibility to antigenic variation. Influenza is highly contagious, and the hallmark of infection is abrupt onset of fever, cough, chills or sweats, myalgias, and malaise. For most patients in the outpatient setting, the diagnosis is made clinically, and laboratory confirmation is not necessary. Laboratory testing may be useful in hospitalized patients with suspected influenza and in patients for whom a confirmed diagnosis will change treatment decisions. Rapid molecular assays are the preferred diagnostic tests because they can be done at the point of care, are highly accurate, and have fast results. Treatment with one of four approved anti-influenza drugs may be considered if the patient presents within 48 hours of symptom onset. The benefit of treatment is greatest when antiviral therapy is started within 24 hours of symptom onset. These drugs decrease the duration of illness by about 24 hours in otherwise healthy patients and may decrease the risk of serious complications. No anti-influenza drug has been proven superior. Annual influenza vaccination is recommended for all people six months and older who do not have contraindications.
Assuntos
Influenza Humana/diagnóstico , Influenza Humana/terapia , Antivirais/uso terapêutico , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/complicações , Influenza Humana/epidemiologiaAssuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Farmacorresistência Bacteriana , Uso de Medicamentos , Staphylococcus aureus Resistente à Meticilina/genética , Mupirocina/administração & dosagem , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Genes Bacterianos , Hospitais de Veteranos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Infecções Estafilocócicas/epidemiologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
A 22-year-old human immunodeficiency virus-infected male presented with fever, rash, hypotension, and renal insufficiency 18 days following initiation of therapy with an efavirenz-based antiretroviral regimen. Although rash is a common side effect of efavirenz, severe hypersensitivity reactions are rare. Systemic symptoms can include hepatic toxicity and pneumonitis, and in one instance death. Corticosteroids are the mainstay of treatment.
Assuntos
Síndrome de Hipersensibilidade a Medicamentos/diagnóstico , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Alcinos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antirretrovirais/farmacologia , Antirretrovirais/uso terapêutico , Benzoxazinas/farmacologia , Benzoxazinas/uso terapêutico , Ciclopropanos , Síndrome de Hipersensibilidade a Medicamentos/complicações , Exantema/etiologia , Febre/etiologia , HIV-1/patogenicidade , Humanos , Masculino , Inibidores da Transcriptase Reversa/farmacologia , Inibidores da Transcriptase Reversa/uso terapêutico , Tenofovir/farmacologia , Tenofovir/uso terapêutico , Trombocitopenia/etiologia , Adulto JovemRESUMO
A 78-year-old Japanese woman with diarrhoea and abdominal pain was admitted for PCR test (PCR)-proven Clostridium difficile colitis. The patient's symptoms persisted despite multiple courses of antibiotics including intravenous metronidazole, oral vancomycin and oral fidaxomicin. She underwent a stool transplant without improvement. Biopsies from a colonoscopy revealed concomitant cytomegalovirus (CMV) infection. The patient was immediately started on intravenous ganciclovir. Unfortunately, she developed sepsis secondary to colitis, and underwent definitive treatment with a total colectomy. Although CMV is a rare colonic pathogen in the immunocompetent patient, it should be considered in patients with severe or refractory C difficile colitis.