upc number generator excel A Uncomplicated Gonorrhea in Objective-C

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For urethritis or cervicitis, either ceftriaxone, 125 mg intramuscularly, or cefpodoxime, 400 mg orally as a single dose, is the treatment of choice Fluoroquinolones are no longer recommended as first-line agents, especially for treatment of gonorrhea in men who have sex with men, because of emerging resistance Spectinomycin, 1 g intramuscularly once, may be used for the penicillin-allergic patient Anal gonorrhea in women responds to the same drugs, but in males ceftriaxone is most effective Pharyngeal gonorrhea is treated by ceftriaxone in the same dosage and by trimethoprim-sulfamethoxazole, nine regular-strength tablets orally daily for 5 days Since coexistent chlamydial infection is common, doxycycline, 100 mg orally twice daily for 7 days, or a single 1 g oral dose of azithromycin, concurrently, should be given unless chlamydial infection has been ruled out with a negative nucleic acid amplification test for C trachomatis; women should be tested for pregnancy before tetracycline is prescribed
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Salpingitis, prostatitis, bacteremia, arthritis, and other complications due to susceptible strains in adults should be treated with penicillin G, 10 million units intravenously daily, for 5 days Ceftriaxone, 1 g intravenously daily for 5 days, or an oral fluoroquinolone (ciprofloxacin, 500 mg twice daily, or levofloxacin, 500 mg once daily) for 5 days also is effective, provided the isolate is susceptible Endocarditis should be treated with ceftriaxone, 2 g every 24 hours intravenously, for at least 3 weeks Postgonococcal urethritis and cervicitis, which are usually caused by chlamydia, are treated with a regimen of erythromycin, doxycycline, or azithromycin as described above Pelvic inflammatory disease requires cefoxitin, 2 g parenterally every 6 hours, or cefotetan, 2 g intravenously every 12
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Granuloma inguinale is a chronic, relapsing granulomatous anogenital infection due to Calymmatobacterium (Donovania) granulomatis The pathognomonic cell, found in tissue scrapings or secretions, is large (25 90 mcm) and contains intracytoplasmic cysts filled with bodies (Donovan bodies) that stain deeply with Wright s stain The incubation period is 8 days to 12 weeks The onset is insidious The lesions occur on the skin or mucous membranes of the genitalia or perineal area They are relatively painless infiltrated nodules that soon slough A shallow, sharply demarcated ulcer forms, with a beefy-red friable base of granulation tissue The lesion spreads by contiguity The
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advancing border has a characteristic rolled edge of granulation tissue Large ulcerations may advance onto the lower abdomen and thighs Scar formation and healing occur along one border while the opposite border advances Superinfection with spirochete-fusiform organisms is common The ulcer then becomes purulent, painful, foulsmelling, and extremely difficult to treat Several therapies are available Because of the indolent nature of the disease, duration of therapy is relatively long The following recommended regimens should be given for 3 weeks or until all lesions have healed: doxycycline, 100 mg orally twice daily; or azithromycin, 1 g orally once weekly; or ciprofloxacin, 750 mg orally twice daily; or erythromycin, 500 mg orally four times a day
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also cause bacillary angiomatosis and persistent bacteremia or endocarditis (which will be culture-negative unless specifically sought), the latter two entities being associated with homelessness Due to the fastidious nature of the organism and its special growth requirements, serologic testing (eg, demonstration of a high antibody titer in an indirect immunofluorescence assay) or nucleic acid amplification tests are often required to establish a diagnosis Bacillary angiomatosis responds to treatment with a macrolide or doxycycline administered in standard doses for 4 8 weeks Bacteremia and endocarditis can be effectively treated with a 6-week course of doxycycline (200 mg orally or intravenously in two divided doses per day) plus gentamicin 3 mg/ kg/d intravenously for the first 2 weeks Relapse may occur
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Foucault C et al Bartonella quintana characteristics and clinical management Emerg Infect Dis 2006 Feb;12(2): 217 23 [PMID: 16494745] Houpikian P et al Blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases Medicine (Baltimore) 2005 May;84(3):162 73 [PMID: 15879906]
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