Current practice in viral sexually transmitted diseases.
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Herpes Genitalis↗
Biomedical subjects
S R Lavoie
Publications and source records attributed to S R Lavoie.
Management of genital herpes infection.
Genital herpes infections are a major source of morbidity. These infections are responsible for significant health problems, including direct physical discomfort associated with outbreaks, potential complications such as neonatal transmission, and the often devastating psychological effects of a chronic illness. In addition, herpes infections have been identified as a significant co-factor in the transmission of human immunodeficiency virus infection. Accurate and rapid diagnosis and treatment are important steps necessary to minimize these effects.
Acyclovir↗
Mixed cutaneous phaeohyphomycosis in a cocaine user.
The dematiaceous fungi rarely cause serious disease in humans. We report a case of mixed cutaneous phaeohyphomycosis caused by two dematiaceous fungi, Exserohilum rostratum and Curvularia species, and review the microbiological characteristics and clinical significance of these organisms.
Adult↗
Eastern equine encephalomyelitis with hematuria and bladder dysfunction.
We have described a patient with eastern equine encephalomyelitis acquired in central Virginia, an area in which EEE is not ordinarily considered endemic. The unusual presenting features of our patient's encephalomyelitis were bladder dysfunction and hematuria as well as prominent mood and affect disturbances, which are usually seen in association with St. Louis encephalitis. The diagnosis of arboviral encephalomyelitis was considered because of the severe CNS manifestations and spinal cord involvement, and was facilitated by the detection of specific IgM antibodies in both the CSF and serum. A high index of suspicion is required to make the diagnosis of EEE, especially in nonendemic areas.
Adult↗
Comparison of ampicillin-sulbactam with vancomycin for treatment of experimental endocarditis due to a beta-lactamase-producing, highly gentamicin-resistant isolate of Enterococcus faecalis.
Increasing antibiotic resistance in the enterococci, including the capacity for beta-lactamase production and the development of high-level aminoglycoside resistance, has complicated the treatment of serious enterococcal infections, which often require synergistic antibiotic combinations for cure. We utilized the rabbit model of aortic valve endocarditis to investigate the effects of various antibiotics, alone and in combination, against a multiply antibiotic-resistant isolate of Enterococcus faecalis. Female New Zealand White rabbits were infected with either a beta-lactamase-producing, gentamicin-resistant isolate of E. faecalis or a non-beta-lactamase-producing, aminoglycoside-susceptible isolate, and the mean log10 CFU per gram of vegetation were determined. The most active agents were low-dose ampicillin-sulbactam (200 mg/kg of body weight per day), high-dose ampicillin-sulbactam (400 mg/kg of body weight per day), and vancomycin (150 mg/kg of body weight per day), which reduced the titers of bacteria by 2.27, 2.76, and 2.85 log10 (CFU/g, respectively, compared with controls. While ampicillin-sulbactam and vancomycin were equally efficacious in reducing titers of bacteria in vegetations, no animals were cured (defined as < 2 log10 CFU/g of vegetation) by either agent, whether treatment was continued for 3 or 7 days. The addition of gentamicin was not associated with increased killing in rabbits infected with the aminoglycoside-resistant isolate. Both high-dose ampicillin-sulbactam and vancomycin regimens demonstrated significant, continued reduction in bacterial titers with the longer periods of treatment (P < or = 0.05); 7-day treatment with high-dose ampicillin-sulbactam produced a greater reduction in bacterial titers in vegetation than 7-day treatment with vancomycin (P < or = 0.05). We conclude that ampicillin-sulbactam and vancomycin are equally effective in the treatment of experimental endocarditis due to beta-lactamase-producing, highly gentamicin-resistant E. faecalis. The optimum therapy for such infections in humans is not known.
Ampicillin↗