Sandbox Jyostna
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- Filariasis Return to Top
- Filariasis
- 1. Lymphatic filariasis- Wuchereria bancrofti, Brugia malayi Brugia timori::- 2. Cutaneous filariasis- Onchocercia volvulus, Loa loa
- Onchocerciasis Return to Top
- Onchoceria volvulus cutaneous filariasis (river blindness) treatmentGilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
- Preferred regimen: Ivermectin Single dose of 150 mcg/kg po; repeat q6-12months until asymptomatic.
- Alternative regimen: If Ivermectin fails, consider Suramin.
- Note (1): Onchocercia and  Loa loa may both be present. Check peripheral smear; if Loa loa microfilaria present, treat onchocercia first with Ivermectin before Diethylcarbamazine (DEC) for Loa loa.
- Note (2): Retreatment for microfilaremia often necessary q6-12 months as demonstrated by repeat blood smear or antigen testing.
- Note (3): Do not use Diethylcarbamazine (DEC) in Onchocerca volvulus due to increased risks of precipitating blindness.
- Treatment of endosymbiont Wolbachia (bacteria) may help clear infection
- Preferred regimen: Doxycycline 100 mg qd or bid for 6-8 wks in lymphatic filariasis although effect may be more important for co-infecting pathogens such as Wuchereria or Onchocerca than loaloa.
- Loiasis Return to Top
- Loa loa cutaneous filariasis (eyeworm disease) treatmentGilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.::- Preferred regimen: Diethylcarbamazine (DEC) escalation recommended to reduce reactions on day 1-50 mg, day 2-50 mg tid, day 3-100 mg tid, Days4-21, 8-10mg/kg/day in 3 divided dose::- Alternative regimen: Albendazole 200mg po bid for 21 days::: Note: If concomitant onchocercia Loa loa, treat oncho first. Ifover 5,000 microfilaria/mL of blood, Diethylcarbamazine (DEC) can cause encephalopathy. Might start with albendazole for few days with or without steroids, then Diethylcarbamazine (DEC).
- Wuchereria bancrofti Return to Top
- Wuchereria bancrofti lymphatic filariasis (elephantiasis) treatment::- Preferred regimen (1): Scaled dose Diethylcarbamazine (DEC) escalation recommended to reduce reactions on day 1-50 mg, day 2-50 mg tid, day 3-100 mg tid, Days 4-14, 2 mg/kg q8h for total of 72 mg over 14 days. (Diethylcarbamazine(DEC) 2 mg/kg PO tid for 12 days (may be accompanied by systemic reaction to dying worms,local reactions include lymphadenitis, transient lymphedema)).::: Note: Corticosteroids or antihistamines may be needed to treat allergic reactions that develop as a consequence of dying microfilariae.
- Preferred regimen (2):  Albendazole 400 mg PO single dose regimen AND (Ivermectin 200 mcg/kg PO OR Diethylcarbamazine 6mg/kg) may reduce or suppress microfilariae; however, this will not affect adultworms.::: Note (1): Most symptoms with Wuchereria bancrofti  are due to the adultworm.::: Note (2): Retreatment for microfilaremia often necessary q6-12 months as demonstrated by repeat blood smear or antigen testing.::: Note (3): Do not use Diethylcarbamazine (DEC) in Onchocerca volvulus due to increased risks of precipitating blindness.
- Treatment of endosymbiont Wolbachia (bacteria) may help clear infection:::- Preferred regimen: Doxycycline 100 mg qd or bid for 6-8 wks in lymphatic filariasis although effect may be more important for co-infecting pathogens such as Wuchereria or Onchocerca than loaloa.
- Brugia malayi Return to Top
- Brugia malayi, Brugia timori lymphatic filariasis (elephantiasis) treatment::- Preferred regimen (1): Scaled dose Diethylcarbamazine (DEC) escalation recommended to reduce reactions on day 1-50 mg, day 2-50 mg tid, day 3-100 mg tid, Days 4-14, 2 mg/kg q8h for total of 72 mg over 14 days. (Diethylcarbamazine(DEC) 2 mg/kg PO tid for 12 days (may be accompanied by systemic reaction to dying worms,local reactions include lymphadenitis, transient lymphedema)).::: Note: Corticosteroids or antihistamines may be needed to treat allergic reactions that develop as a consequence of dying microfilariae.
- Preferred regimen (2):  Albendazole 400 mg PO single dose regimen AND (Ivermectin 200 mcg/kg PO OR Diethylcarbamazine 6mg/kg) may reduce or suppress microfilariae; however, this will not affect adultworms.::: Note :::: Diagnosis 1.serological-antigen detection by commercially available card test ; IgG4 antibody (not filaria species specific and may cross react with other helminths);:::: Diagnosis 2.special maneuvers DEC provocative days test (induce microfilaremia with dose of DEC); polymerase chain reaction.:::: Diagnosis 3.skin snips  (detect Onchocerca volvulus, Mansonella streptocerca). Ultrasonography can detect adult W.bancrofti worms in scrotal lymphatics.
- Echinococcus granulosus (hydatid disease) treatment
- Preferred regimen: Percutaneous aspiration-injection-reaspiration (PAIR) and Albendazole.Before & after drainage:Albendazole 60 kg, 400 mg PO bid or <60 kg, 15 mg/kg per day divided bid, with meals. Then: Puncture (P) & needle aspirate (A) cyst content. Instill (I) hypertonic saline (1530%) or absolute alcohol, wait 2030 min, then re-aspirate (R) with final irrigation.
- Echinococcus multilocularis (alveolar cyst disease) treatment
- Preferred regimen: Albendazole 60 kg, 400 mg PO bid or <60 kg, 15 mg/kg per day divided bid, with meals.
- Neurocysticercosis treatment (NCC)
- 1 Larval form of Taenia solium
- Preferred regimen: Treat Taenia solium intestinal tapeworms, if present, with Praziquante l5-10 mg/kg PO for 1 dose for children & adults.
- 2 Parenchymal neurocysticercosis
- Preferred regimen: Patients body weight of 60 kg,Albendazole 400mg bid with meals or Patients body weight of 60 kg,Albendazole 15 mg/kg per day in 2 divided doses (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg per day with or without anti-seizure medication] all for 8-30 days
- Alternative regimen: (Praziquantel 100 mg/kg per day in 3 div. doses PO for 1 day, then 50 mg/kg/d in 3 doses and } ANDDexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
- 3 Degenerating cysts
- Preferred regimen: Patients body weight of 60 kg,Albendazole 400mg bid with meals or Patients body weight of 60 kg,Albendazole 15 mg/kg per day in 2 divided doses (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg per day with or without anti-seizure medication] all for 8-30 days
- 4 Subarachnoid neurocysticercosis
- Preferred regimen: (Patients body weight of 60 kg,Albendazole 400mg bid with meals or Patients body weight of 60 kg,Albendazole 15 mg/kg per day in 2 divided doses (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg per day with or without anti-seizure medication] all for 8-30 days) AND shunting for hydrocephalus.
- 5 Intraventricular neurocysticercosis
- Preferred regimen: Albendazole AND dexamethasone AND perhaps neuroendoscopic removal if obstruction of CSF circulation
- Sparganosis (Spirometra mansonoides) treatment
- Preferred treatment: Surgical resection or ethanol injection of subcutaneous masses
- Body lice
- Pediculus humanus, corporis treatment
- Preferred regimen (1): Success with Ivermectin in home shelter with 12 mg PO on days 0, 7, & 14
- Preferred regimen (2): Treat clothing with 1% Malathion powder OR 0.5% Permethrin powder.
- Head lice
- Pediculus humanus, capitis treatment
- Preferred regimen: Permethrin 1% lotion apply to shampooed dried hair for 10 min.; repeat in 9-10 days OR Malathion 0.5% lotion (Ovide) apply to dry hair for 812hrs, then shampoo. 2 doses 7-9 days apart.
- Alternative regimen: Ivermectin 200 g/kg PO once; 3 doses at 7 day intervals reported effective. Malathion 0.5% lotion report that 12 20-minutes applications 98% effective.
- Myiasis
- Fly larvae treatment 
- Preferred treatment (1): Occlude punctum to prevent gas exchange with petrolatum, fingernail polish, makeup cream or bacon.
- Preferred treatment (2): When larva migrates, manually remove.
- Pubic lice
- Phthirus pubis treatment
- Scabies
- Sarcoptes scabiei treatment
- 1. Immunocompetent patisent
- Preferred regimen: (Primary) Permethrin 5% cream (ELIMITE).
- Alternative regimen: Ivermectin 200 g/kg PO once. As above, second dose if persistent symptoms.
- Alternative regimen (2): Less effective is Crotamiton 10% cream, apply for 24 hours, rinse off, then reapply for 24 hours.
- 2. AIDS patients (CD4 <150 per mm3), debilitated or developmentally disabled patients
- Alternative regimen: Ivermectin 200 mcg/kg PO once is reported effective; may need 2 or more doses separated by 14 days.
- 5. Adenovirus treatment 
- 1. In severe cases of pneumonia or post  Hematopoietic stem cell transplantation
- Preferred regimen: Cidofovir  5 mg/kg/wk for 2 wks, then q 2 wks AND Probenecid 1.25 gm/M given 3hrs before cidofovir and 3 & 9 hrs after each infusion OR Cidofovir 1 mg/kg IV 3 times/wk.
- 2. For hemorrhagic cystitis
- 3. Pink eye (viral conjunctivitis)
- 4.Bronchitis
-  Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
-  Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
-  Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.