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  • Image not available. All symptomatic adults and children older than 8 years of age with giardiasis can be treated with metronidazole 250 mg 3 times daily for 5 to 10 days, or tinidazole 2 g once, or nitazoxanide 500 mg twice daily for 3 days.
  • Image not available. Amebic liver abscesses can spread to the lungs and pleura. Pericardial infections, although rare, may be associated with extension of the amebic abscess from the left lobe of the liver. Erosion of liver abscesses also present as peritonitis.
  • Image not available. Asymptomatic cyst passers and patients with mild intestinal amebiasis should receive one of the following luminal agents: paromomycin 25 to 35 mg/kg/day 3 times daily for 7 days, iodoquinol 650 mg 3 times daily for 20 days, or diloxanide furoate 500 mg 3 times daily for 10 days.
  • Image not available.Mebendazole (Vermox), an oral synthetic benzimidazole, is the agent of first choice for hookworm. It is also effective against ascariasis, enterobiasis, and trichuriasis.
  • Image not available. Administration of corticosteroids or other immunosuppressive drugs to an infected individual with strongyloidiasis can result in hyperinfections and disseminated strongyloidiasis.
  • Image not available. The most serious complication of cysticercosis is invasion of the central nervous system which results in neurocysticercosis. Neurocysticercosis can cause obstructive hydrocephalus, strokes, and seizures; antihelminthic treatment for these conditions remains controversial.
  • Image not available. When intravenous quinidine is not readily available, intravenous artesunate (available under an investigational new drug (IND) from the CDC at www.cdc.gov/malaria/features/artesunate_now_available.htm), a water-soluble artemisinin derivative, administered at 2.4 mg/kg/dose for 3 days at 0, 12, 24, 48, and 72 hours is the recommended drug if severe Plasmodium falciparum is suspected.
  • Image not available. Because falciparum malaria is associated with serious complications, including pulmonary edema, hypoglycemia, jaundice, renal failure, confusion, delirium, seizures, coma, and death, careful monitoring of fluid status and hemodynamic parameters is mandatory. Either hemofiltration or hemodiafiltration is indicated in renal failure.
  • Image not available. The drugs that have been used to treat Trypanosoma cruzi infections include nifurtimox (Lampit, Bayer 2502) and benznidazole (Rochagan).
  • Image not available.Permethrin (1% and 5%) for pediculosis and scabies, respectively, is the preferred agent and remains the safest agent, especially in infants and children.

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Upon completion of the chapter, the reader will be able to:

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  • 1. List the key diagnostic features that may allow clinicians to identify parasitic infections in U.S. patients.
  • 2. Identify the host conditions that make one susceptible to parasitic infections.
  • 3. Describe the treatment algorithm for amebic liver abscess.
  • 4. Cite the drugs of choice for giardiasis and asymptomatic amebiasis.
  • 5. List the drug of choice for ascariasis.
  • 6. Identify the agents that can lead to hyperinfection of stronglyloidiasis in patients.
  • 7. Evaluate the role of drug therapy in neurocysticercosis.
  • 8. List four major reasons why United States travelers are infected with malaria.
  • 9. Determine the definitive role of primaquine in the treatment of malaria.
  • 10. List the parenteral antimalarial drug(s) for severe malaria if quinidine is not readily available.
  • 11. Identify the major contraindication(s) for use of mefloquine in malaria.
  • 12. Define the major complications of falciparum malaria.
  • 13. Identify the ...

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