Tryposomal chancre Periods of febrile illness (hemolympriatic stage) lasting for one week or more and accompanied

trypanosomiasis - Tryposomal chancre Periods of febrile illness (hemolympriatic stage) lasting for one week or more and accompanied by severe headache, general malaise, myalgia and joint pains, and progressive lymphadenopathy (especially In T brucei gambiensee infection) Transitory erythematous rash (circinate erythema) Other organ lesions may develop - myocarditis, splenomegaly, hepatomegaly Meningoencephalitis may develop during the course of infection. Diagnosis - Trypanosomes in blood or tiesuelluid Immunodlagnostic tests - Indrect fluorescence antibody test (IFAT) and ELISA. CSF In case of meningo-encephalitis. 20 Melioidose with acute sepsticemia Clinical features of Gram-negative septicemia with melaslalic abscesses particularly in lungs, liver and spleen Diagnose - Demonstration of bipolar Gram-negative rods in films of pus or secretions Culture - Isolation of Pseudomonas pseudomallei 21. Opportunistic infections of AIDS - See AIDS Management I. Specific - (a) Chloramphenicol - 500 mg 6-hourly till temperurature comes 10 normal, then 500 mg 8-hourly until next day. When oral admisteiraiion is not possible, it can be given in doses of 1 gm. IM every 12 hours For chidren about half the adult dose, as syrup of stearate or palmitate containing In each 4 ml. ( one teaspoonful ) 125 mg of Chloramphenicol No longer drug of choice because of increasing resistance Also danger of bone marrow suppression (b) Quinolones - First drug of choice. Drugs and dosage schedules: Olloxacin 200 mg b d for 7-14 days Clprofloxacln 750 mg b.d till afebrile. Then 500 mg b.d for 7-14 days Pefloxacln 400 mgb.d for 7-14 days Nortloxacln 800 mg b.d. till alebrlle. then 400 mg b d for 7-14 days, (c) Third generation cephalosporlns -Indications (i) Clprofloxaciri resistance (II) Typhoid meningitis (iii) Enreric lever In pregnancy and those <17>