User what is gonorrhea?4 answersGonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It is a major global health concern due to its high prevalence, asymptomatic cases, severe sequelae, and increasing antibiotic resistance. The infection primarily affects the genital tract but can also involve other mucosal sites like the pharynx and rectum, with potential spread to systemic sites. Gonorrhea disproportionately affects women and infants, often leading to serious complications if left untreated, such as infertility and blindness in newborns. Screening is crucial for early detection, especially in high-risk populations, and treatment typically involves cephalosporin antibiotics due to widespread resistance to other drugs. The WHO, CDC, and other health organizations have identified the urgent need for new therapeutics and a vaccine to combat this persistent public health threat.
What are the clinical manifestations of tick-borne diseases?4 answersTick-borne diseases can have a range of clinical manifestations. Common symptoms include fever, headache, myalgia, and rash. Tick-borne diseases can also cause hepatological manifestations, such as liver enzyme elevation, cholestasis, and jaundice. Lyme disease, the most common tick-borne disease in the US, can present with mild transaminitis and hepatocellular injury. Rocky Mountain spotted fever (RMSF) can cause cholestatic liver injury. Human monocytic ehrlichiosis and human granulocytic anaplasmosis can both lead to cholestatic hepatitis and liver failure. Tularemia can result in marked cholestasis and jaundice. Babesiosis can cause mild elevations in transaminases and indirect hyperbilirubinemia. Colorado tick fever and tick-borne relapsing fever (TBRF) can both lead to hepatocellular necrosis and hepatic failure. Q fever can cause focal hepatocellular necrosis and granulomatous disease. Dermatological manifestations are also common in tick-borne diseases, including Heartland Virus, Bourbon Virus, Powassan Virus, Deer Tick Virus, and Colorado Tick Fever Virus.
What evidence exists on the timing of antibiotics for gonorrhea to avoid harms, including overtreatment, undertreatment, and antibiotic resistance?5 answersPresumptive antibiotic treatment for gonorrhea and chlamydia infections before a laboratory diagnosis is established can lead to overtreatment, undertreatment, and antibiotic resistance. In an urban academic emergency department (ED) setting, the prevalence of presumptive treatment for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infections was found to be low, with only 13% receiving presumptive treatment for CT and 9% for GC. Delay to treatment was also observed, with a mean delay of 10 days, including a mean of 3 days for laboratory analysis. Another study showed that rapid diagnostics reporting antibiotic susceptibility profiles could delay the spread of antibiotic resistance in gonorrhea. The use of a point-of-care (POC) test reporting antibiotic susceptibility profiles resulted in a delay of 5 years in the emergence of resistance to azithromycin and ceftriaxone, and a delay of 6 years in the emergence of triply-resistant strains. Monitoring resistance patterns will be critical with the introduction of such tests.
What is the clinical presentation of syphilis?5 answersThe clinical presentation of syphilis can vary depending on the stage of infection. Common manifestations include periorbital swelling, hematuria, proteinuria, and rapidly progressive renal failure. Other symptoms may include repeated upper respiratory tract infections/coryza, skin lesions, poor weight gain, conjunctivitis, pallor/anemia, wasting, and underweight in infants with congenital syphilis. Syphilis can also present as left eye redness and decreased vision, indicating syphilitic anterior uveitis as a complication of neurosyphilis. In some cases, syphilis can masquerade as a head and neck malignancy, leading to a difficult diagnosis. It is important for clinicians to consider syphilis as a potential cause when presented with these clinical features, regardless of the patient's HIV status.
What is the clinical presentation of naso sinusal diseases?5 answersThe clinical presentation of naso sinusal diseases can vary depending on the specific condition. Nasolabial cysts, for example, typically present with facial asymmetry and may cause discharging sinus. T-acute lymphoblastic leukemia (T-ALL) can manifest as a nasal cavity tumor, initially misdiagnosed as T-cell lymphoma, with elevated white blood cell count and aberrant CD56 expression. Naxos disease, a recessively inherited cardiomyopathy, presents with symptoms such as syncope and sustained ventricular tachycardia. Functional endoscopic sinus surgery (FESS) can have complications, which are the number one reason for malpractice claims in otorhinolaryngology. Preventive and therapeutic measures for FESS complications are crucial, and up-to-date knowledge and training can help reduce the complications rate. The management of nose- and sinus-related clinical problems involves accurate ENT evaluation in a primary care setting and emphasizes the importance of nasal hygiene for prevention of rhinosinus disease.
What are the susceptibility of Neisseria gonorrhoeae?2 answersNeisseria gonorrhoeae is susceptible to protegrins, a family of small beta-sheet antimicrobial peptides derived from mammalian leukocytes. It is also susceptible to six antibiotics including penicillin, ampicillin, tetracycline, erythromycin, chloramphenicol, and cephaloridine. The susceptibility of N. gonorrhoeae to drying is well recognized. Additionally, there have been reports of high-level resistance to azithromycin in N. gonorrhoeae isolates in the United States. The emergence of broad-spectrum antibiotic resistance has posed challenges in the treatment of N. gonorrhoeae infections.