Persius/hicric huggingface dataset:
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- Risk categories for antimicrobial agents known to have an association with TdP
- Drugs with known TdP risk
- Azithromycin (Zithromax, Zmax)
- Chloroquine (Aralen)
- Ciprofloxacin (Cipro, Cipro-XR, Neofloxin)
- Clarithromycin (Biaxin, Prevpac)
- Erythromycin (A/T/S, Akne-Mycin, Emgel, Ery-Tab, Eryc, Erycette, Eryderm, Erygel)
- Fluconazole (Diflucan, Trican)
- Halofantrine (Halfan)
- Levofloxacin (Levaquin, Tavanic)
- Moxifloxacin (Avelox, Avalox, Avelon)
- Pentamidine (Pentam)
- Sparfloxacin (Zagam)
- Drugs with possible TdP risk
- Atazanavir (Reyataz)
- Bedaquiline (Sirturo)
- Dihydroartemisinin-Piperaquine (Eurartesim)
- Foscarnet (Foscavir)
- Gatifloxacin (Tequin)
- Gemifloxacin (Factive)
- Norfloxacin (Noroxin, Ambigram)
- Ofloxacin (Floxin)
- Rilpivirine (Edurant, Complera, Eviplera)
- Roxithromycin (Rulide, Xthrocin, Roxl-150, Roxo, Surlid, Rulide, Biaxsig, Roxar, Roximycinv, Roxomycin, Rulid, Tirabicin, Coroxin)
- Saquinavir (Invirase(combo))
- Telavancin (Vibativ)
- Telithromycin (Ketek)
- Drugs with conditional TdP risk
- Amantadine (Symmetrel, Symadine)
- Hydroxychloroquine (Plaquenil, Quineprox)
- Itraconazole (Sporanox, Onmel)
- Ketoconazole (Nizoral, Sebizole, Ketomed, Keton)
- Metronidazole (Flagyl and many others)
- Nelfinavir (Viracept)
- Posaconazole (Noxafil, Posamol)
- Quinine sulfate (Qualaquin)
- Ritonavir (Norvir)
- Telaprevir (Incivek, Incivo)
- Voriconazole (VFend)
- Drugs to be avoided by congenital Long QT
- Trimethoprim-Sulfamethoxazole (Septra, Bactrim, Sulfatrim, Biseptol, Co-trimoxazole, Cotrim, Septrin, Trisul)
- Torsades de pointes risk stratification schedules for antimicrobial agents
- Schedule I (Highest TdP risk, potent IKr blockers, TdP risk >1%)
- Not available
- Schedule II (Significant risk for TdP, particularly when coadministered with CYP inhibitors, relatively potent IKr blockade)
- Not available
- Schedule III (Risk for TdP is described, IKr blockade, particularly when coadministered with CYP inhibitors)
- Clarithromycin (Biaxin, Prevpac)
- Erythromycin (A/T/S, Akne-Mycin, Emgel, Ery-Tab, Eryc, Erycette, Eryderm, Erygel)
- Itraconazole (Sporanox, Onmel)
- Ketoconazole (Nizoral, Sebizole, Ketomed, Keton)
- Pentamidine (Pentam)
- Sparfloxacin (Zagam)
- Schedule IV (Minimal risk for TdP, case reports of TdP, mild IKr blockade, may have CYP interactions)
- Fluconazole (Diflucan, Trican)
- Gatifloxacin (Tequin)
- Gemifloxacin (Factive)
- Levofloxacin (Levaquin, Tavanic)
- Moxifloxacin (Avelox, Avalox, Avelon)
- Telithromycin (Ketek)
- Voriconazole (VFend)
- Schedule V (Questionable or minimal risk for QT interval prolongation or TdP)
- Azithromycin (Zithromax, Zmax)
- Ciprofloxacin (Cipro, Cipro-XR, Neofloxin)
- Trimethoprim-Sulfamethoxazole (Septra, Bactrim, Sulfatrim, Biseptol, Co-trimoxazole, Cotrim, Septrin, Trisul)
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- Cerebrospinal fluid shunt infection
- Empiric antimicrobial therapy
- Preferred regimen: Vancomycin 3045 mg/kg/day IV q812h AND (Cefepime 2 g IV q8h OR Ceftazidime 2 g IV q8h OR Meropenem 2 g IV q8h)
- Pathogen-directed antimicrobial therapy
- Enterococcus
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h) AND Gentamicin 11.7 mg/kg IV q8h
- Gram-negative bacilli
- Preferred regimen: Ceftriaxone 2 g IV q12h OR Cefepime 2 g IV q12h OR Meropenem 2 g IV q8h OR Aztreonam 2 g IV q6h
- Propionibacterium acnes
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h)  Gentamicin 11.7 mg/kg IV q8h
- Staphylococcus, coagulase-negative
- Preferred regimen: Vancomycin 3045 mg/kg/day IV q812h  Rifampin 600 mg IV/PO q24h
- Staphylococcus aureus, methicillin-resistant
- Preferred regimen: Vancomycin 3045 mg/kg/day IV q812h  Rifampin 600 mg IV/PO q24h
- Staphylococcus aureus, methicillin-susceptible
- Preferred regimen: (Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h)  Rifampin 600 mg IV/PO q24h
- Streptococcus agalactiae
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h) AND Gentamicin 11.7 mg/kg IV q8h
- Fungi
- Preferred regimen: Amphotericin B 0.61.0 mg/kg IV q24h OR Amphotericin B liposomal 5 mg/kg/day IV q24h
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# Tropical sprue
- Tropical sprue
- Preferred regimen: Folic acid 5 mg PO bid for 2 weeks, followed by 1 mg PO tid AND (Tetracycline 250 mg PO qid OR Doxycycline 100 mg PO qd for 46 weeks, up to 6 months in residents of the tropics who have had long-term disease)
- Alternative regimen: Folic acid 5 mg PO bid for 2 weeks, followed by 1 mg PO tid AND Ampicillin 500 mg bid for  4 weeks
-  Guerra, R.; Wheby, M. S.; Bayless, T. M. (1965-10). "Long-term antibiotic therapy in tropical sprue". Annals of Internal Medicine. 63 (4): 619634. ISSN 0003-4819. PMID 5838328. Check date values in: |date= (help).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}
-  Ferri, Fred (2015). Ferri's Clinical Advisor 2016 5 Books in 1. City: Elsevier Science Health Science. ISBN 978-0323280471.
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# Meningitis, MRSA
- Meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA)
- Preferred regimen: Vancomycin 3045 mg/kg/day IV q812h for 2 weeks
- Alternative regimen: Linezolid 600 mg PO/IV q12h OR TMP-SMX 1020 mg/kg/day IV q612h
- Pediatric regimen: Vancomycin 1520 mg/kg IV q6h OR Linezolid 10 mg/kg PO/IV q8h
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# Sterile pyuria
- Sterile pyuria
- Definitions
- Pyuria: the presence of 10 or more white cells per cubic millimeter in a urine specimen, 3 or more white cells per high-power field of unspun urine, a positive result on Grams stain of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase
- Sterile pyuria: the persistent finding of white cells in the urine in the absence of bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate)
- Bacteriuria: bacterial colony counts of more than 1000 colony-forming units (CFU) per milliliter in urine
- Causes
- Infectious etiologies
- Gynecologic infection
- Urethritis due to chlamydia, Neisseria gonorrhoeae, mycoplasma, or ureaplasma
- Prostatitis
- Balanitis
- Appendicitis
- Viral infection of the lower genitourinary tract
- Genitourinary tuberculosis
- Fungal infection
- Parasitic disease such as trichomoniasis or schistosomiasis
- Non-infectious etiologies
- Current use of antibiotics
- Recently treated urinary tract infection (within past 2 weeks)
- Presence or recent use of a urinary catheter
- Recent cystoscopy or urologic endoscopy
- Urinary tract stones
- Foreign body such as surgical mesh in the urethra or a retained stent
- Urinary tract neoplasm
- Pelvic irradiation
- Urinary fistula
- Polycystic kidney
- Rejection of a renal transplant
- Renal-vein thrombosis
- Interstitial nephritis or analgesic nephropathy
- Papillary necrosis
- Interstitial cystitis
- Inflammatory disease such as systemic lupus erythematosus or Kawasakis disease
- Pathogen-directed antimicrobial therapy
- Tuberculosis
- Preferred regimen: Isoniazid AND Rifampin AND Ethambutol AND Pyrazinamide for 36 months
- Gonorrhea
- Preferred regimen: Ceftriaxone 250 mg IM in a single dose, then (Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days)
- Chlamydia
- Preferred regimen: Azithromycin 1 g PO in single dose OR Doxycycline 100 mg PO bid for 7 days
- Alternative regimen: Erythromycin base 500 mg PO qid for 7 days
- Mycoplasma and ureaplasma
- Preferred regimen: Azithromycin OR Levofloxacin OR Moxifloxacin
- Genital herpes
- Preferred regimen: Acyclovir 400 mg PO tid for 710 days or Acyclovir 200 mg PO five times a day for 710 days OR Famciclovir 250 mg PO tid for 710 days OR Valacyclovir 1 g PO bid for 7 days
- Trichomoniasis
- Preferred regimen: Metronidazole 2 g PO in a single dose) OR Tinidazole 2 g PO in a single dose
- Fungal infections
- Preferred regimen: Fluconazole OR Posaconazole OR Echinocandins OR Amphotericin B
- Schistosomiasis
- Preferred regimen: Praziquantel 20 mg/kg PO bid for 12 days
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- Bacillus subtilis
- 1. Food poisoning
- Preferred regimen: supportive treatment
- 2. Other infections
- Preferred regimen: Vancomycin OR Clindamycin
- Alternative regimen: Ciprofloxacin OR Imipenem
-  Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013..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}
-  Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
-  Andrews, J. M.; Wise, R. (2002-06). "Susceptibility testing of Bacillus species". The Journal of Antimicrobial Chemotherapy. 49 (6): 10401042. ISSN 0305-7453. PMID 12039902. Check date values in: |date= (help)
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- Klebsiella rhinoscleromatis Return to Top
- 1. Rhinoscleroma
- Preferred regimen (1): Ciprofloxacin 500750 mg PO bid for 23 months OR Levofloxacin 750 mg PO qd for 23 months
- Preferred regimen (2): Trimethoprim-Sulfamethoxazole 1 DS tab PO bid for 3 months AND Rifampicin 300 mg PO bid for 3 months
- Alternative regimen: Tetracycline OR Streptomycin OR Doxycycline  OR Ceftriaxone OR Ofloxacin
- Note (1): The optimal duration of antimicrobial therapy remains unclear. A 6-week to 6-month cours of antibiotics until histology exams and cultures are negative may be required.
- Note (2): Use of topical antiseptics such as Acriflavinium and Rifampin ointment has been reported with resolution of symptoms.
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- HHV-7 Return to Top
- Most patients with infection with HHV-7 will be asymptomatic. It is unknown whether treatment in asymptomatic patients will lead to a reduction in subsequent infection. (15504215)
- Immunocompetent hosts with uncomplicated skin manifestations associated with HHV-7, particularly roseola infantum and pityriasis rosea, need only symptomatic management. (22819486)
- For HIV-positive patients, antiretroviral therapy may be advisable. (sanford)
- There are no defined circumstances that warrant specific antiviral therapy for HHV-7. (10578120)
- The most active antiviral compounds against HHV-7 are Cidofovir and Foscarnet. (11747000)
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- Mycoplasma pneumoniae Return to Top
- 1. Mycoplasma pneumoniae infections
- Preferred regimen (1): Azithromycin 500 mg PO qd on day 1 and 250 mg PO qd on days 2 to 5
- Preferred regimen (2): Doxycycline 100 mg PO bid for 14 days
- Preferred regimen (3): Moxifloxacin 400 mg PO qd for 14 days
- Preferred regimen (4): Levofloxacin 750 mg PO qd for 14 days
- Preferred regimen (4): Clarithromycin 500 mg PO qd for 14 days
-  Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013..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}
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- Staphylococcus haemolyticus Return to Top
- 1. Methicillin-susceptible strain
- Preferred regimen (1): Nafcillin 12 g IV q4-6h (maximum 12 g/day)
- Preferred regimen (2): Oxacillin 12 g IVq4-6h (maximum 12 g/day)
- Preferred regimen (3): Cefazolin 0.52 g IV q6-8h
- Alternative regimen (1): TMP-SMX 45 mg/kg IV q612h
- Alternative regimen (2): Doxycycline 100200 mg IV q12-24h
- 2. Methicillin-resistant, Glycopeptide-susceptible strain
- Preferred regimen: Vancomycin 1520 mg/kg IV q812h
- 3. Methicillin-resistant, Glycopeptide-resistant strain
- Preferred regimen (1): Daptomycin 46 mg/kg IV q24h
- Preferred regimen (2): Linezolid 600 mg PO/IV q12h
- Staphylococcus saprophyticus Return to Top
- 1. Urinary tract infections
- Preferred regimen (1): Cephalexin 500 mg PO qid
- Preferred regimen (2): Amoxicillin-Clavulanate 875/125 mg PO bid
- Preferred regimen (3): TMP-SMX 160800 mg PO bid
- Alternative regimen: Levofloxacin 500 mg PO qd
- Streptococcus anginosus Return to Top
- 1. Dental abscess
- Preferred regimen: Penicillin V 500 mg PO qid
- Alternative regimen: Vancomycin 1520 mg/kg IV q812h
- 2. Brain abscess
- Preferred regimen (1): Penicillin G 1824 MU/day IV q46h
- Preferred regimen (2): Ceftriaxone 2 g IV q12h
- Alternative regimen: Vancomycin 1520 mg/kg IV q812h
- Bacillus cereus Return to Top
- 1. Food poisoning
- Preferred regimen: Food poisoning is usually self-limited and requires no antibiotic therapy.
- 2. Bacteremia
- Preferred regimen: Vancomycin 15 mg/kg IV q12h
- Alternative regimen: Clindamycin 600 mg IV q8h
- Note (1): Bacillus cereus is commonly resistant to beta-lactams.
- Note (2): Pseudobacteremia is transient and usually results from contaminated blood cultures, gloves, or syringes.
- 3. Meningitis or brain abscess
- Preferred regimen: Vancomycin 15 mg/kg IV q12h
- Alternative regimen: Clindamycin 600 mg IV q8h
- Note: Blood culture isolates are mostly contaminates until proven otherwise, especially in intravenous drug user population.
- 4. Endophthalmitis
- Preferred regimen: Clindamycin 450 g intravitreal AND Gentamicin 400 g intravitreal OR Dexamethasone intravitreal AND Vancomycin 15 mg/kg IV q12h
- Alternative regimen: Clindamycin 600 mg IV q8h
- Note: Ophthalmological consultation, culture ocular fluids, early vitrectomy, and intravitreal antibiotics are necessary.
- 5. Endocarditis
- Preferred regimen: Vancomycin 15 mg/kg IV q12h
- Note: Most blood cultures in intravenous drug users are contaminates or represent transient bacteremia.
- 6.  Soft tissue infection
- Preferred regimen: Vancomycin 15 mg/kg IV q12h
- Alternative regimen: Clindamycin 600 mg IV q8h
- 7. Pneumonia
- Preferred regimen: Vancomycin 15 mg/kg IV q12h
- Alternative regimen: Clindamycin 600 mg IV q8h
- Elizabethkingia meningoseptica Return to Top
- 1. Bacteremia
- Preferred regimen (1): Levofloxacin 750 mg IV/PO q24h
- Preferred regimen (2): TMP-SMX 810 mg/kg/day IV divided q68h
- Alternative regimen (1): Ciprofloxacin 400 mg IV q12h
- Alternative regimen (2): TMP-SMX 810 mg/kg/day IV divided q68h
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Peptic ulcer disease symptoms
A positive history of epigastric pain ,loss of appetite and weight loss  are suggestive of peptic ulcer disease .
Common symptoms :
- Epigastric pain(gastric ulcer -pain increased with taking food and duodenal ulcer decreased with food intake )
- Indigestion
- Nausea, vomiting
- Hematemesis (blood in the vomitus )
- Blood in stools
- Loss of appetite
- Weight loss

# Preferred Template Statements
IF there is one particularly identifiable symptom of the disease:
- The hallmark of  is . A positive history of  and  is suggestive of . The most common symptoms of  include , , and .
IF there are many equally recognizable symptoms of the disease:
- Symptoms of  include , , and .
IF it makes sense to distinguish between common and less-common symptoms:
- On the overview page, use a full sentence:
Common symptoms of  include , , and .
Less common symptoms of  include , , and .
- Common symptoms of  include , , and .
- Less common symptoms of  include , , and .
- On the History and Symptoms microchapter, use bullet points:
Common symptoms of  include:
- Common symptoms of  include:
IF symptoms are usually not present:
- The majority of patients with  are asymptomatic.

# History
- Here you should describe the important components in the patients history that should be given particular focus. Remember to include pertinent points from the past medical history, family history, social history (including occupational, alcohol use with amount and frequency, smoking, drug use) and allergies.
- Remember this is not the section to describe the natural history of the disease or the historical perspective.
- For an example of the history section within the history and symptoms page, click here.
==Common Symptom:
- Epigastric pain(gastric ulcer -pain increased with taking food and duodenal ulcer decreased with food intake )
- Indigestion
- Nausea, vomiting
- Hematemesis (blood in the vomitus )
- Blood in stools
- Loss of appetite
- Weight loss

# Less Common Symptoms
- In this section you can list the less common symptoms that the patient may experience.
- For an example of the the less common symptoms section within a history and symptoms page, click here.
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# Streptococcus pneumoniae

# Neisseria meningitidis

# Listeria Monocytogenes and Streptococcus agalactiae

# Haemophilus influenzae

# Staphylococcus aureus

# Staphylococcus epidermidis and Acinetobacter baumannii

# Enterobacteriaceae and Pseudomonas aeruginosa
 MIC = minimum inhibitory concentration.Addition of rifampicin can be considered if the organism is susceptible, the expected clinical or bacteriological response is delayed, or the cefotaxime/ceftriaxone MIC of the pneumococcal isolate is >4.0 g/mL organism is susceptible, the expected clinical or bacteriological response is delayed, or the cefotaxime/ceftriaxone MIC.
 No clinical data exist for use of this agent in patients with pneumococcal meningitis; recommendation is based on cerebrospinal fluid penetration and in-vitro activity against S. pneumoniae.
 Addition of an aminoglycoside should be considered; might need intraventricular or intrathecal administration in Gram-negative meningitis.
 Addition of rifampicin should be considered.
 Choice of a specific agent should be based on in-vitro susceptibility testing.
 Might also need to be administered by the intraventricular or intrathecal routes.
 Might also need to be administered by the intraventricular or intrathecal routes.
 Addition of rifampicin should be considered.
 The fluoroquinolones gatifloxacin and moxifloxacin pene trate the CSF effectively and have greater in-vitro activity against Gram-positive bacteria than do their earlier counterparts (eg, ciprofloxacin). Findings from experi mental meningitis models suggested their efficacy in S. pneumoniae meningitis, including that caused by penicillin-resistant and cephalosporin-resistant strains. Although one controlled trial suggested the fluoroquinolone trovafl -oxacin mesilate to be as eff  ective as ceftriaxone, with or without the addition of vancomycin, for paediatric bacterial meningitis, no clinical trials describe the use of gatifloxacin or moxifloxacin to treat bacterial meningitis in human beings. Trovafloxacin and gatifloxacin have been asso ciated with serious hepatic toxicity and dysglycaemia, respectively, and were with drawn from many markets. The IDSA guidelines recommend moxifloxacin as an alternative to third-generation cephalosporins plus vancomycin for meningitis caused by S. pneumoniae strains resistant to penicillin and third-generation cephalosporins, although some experts recom mend that this agent should not be used alone but rather should be combined with another drug (either vancomycin or a third-generation cephalosporin), because of the absence of clinical data supporting its use.
Sardonicism
Sardonicism (connected with guffaw) characterizes as distinct from Sarcasm not a contumely or bitter, but a ferocious, painful derision.

# Origin
The aborigines of Sardinia Template:Lang-la would kill their elderly and laugh while doing this. This is called sardonic laughter, or the infamous "Risus sardonicus", a convulsive laughing, with which the soul is noninvolved.  Template:Lang-it,  Template:Lang-fr.
It was already established in the Ancient Greece. They also differentiated between cynic (kynikos "to the world opinion of the cynics"), sardonic (sardanios "the scornful laughter of an angry person, with own pain or own damage") and sarcastic (sarkastikos "derision, hurtful speech"). So Odysseus after he had at last returned laughed sardonic to himself when he dodged a foot of a cow, which was thrown by a punter of his wife.
Occasionally, the convulsive laugh is traced back to a bitter Sardinian plant called "sardanion". The Meyers Encyclopedia from 1888 says Sardoniasm was a: .mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 40px}.mw-parser-output .templatequote .templatequotecite{line-height:1.5em;text-align:left;padding-left:1.6em;margin-top:0}
convulsive, with heavy changing contortion of the face connected, laugh without an exterior cause. The word can be found also in Homer's Odyssee, 20, 302 and should be caused by a  Sardinian cabbage (according  to Virgil: Sardoa herba), which screws up one's mouth to a laugh. Who eats of it, its face screws up itself to an involuntarily grinning laugh. Also newer works refer the origin of the convulsive laugh to the plant Sardonia.

# Ranunculus
The term sardonic (sardanios) "bitter or scornful laughter", which is often cited as deriving from the Sardinian plant (Ranunculus sardous), known as either Template:Polytonic (sardane) or  (sardonion).  When eaten, it would cause the eater's face to contort in a look resembling scorn (generally followed by death).  It might also be related to  (sairo) "I grin".