Archive

Candida Vaginitis

#

1. Symptoms

    1. diabetic

    2. use of OCP

    3. pregnancy

    4. caseous, non malodor, pruritic, whitish discharges

2. Treatment

    1. Tab fluconazole 150mg #1 SD

    2. Vaginal cream clotrimazole 1% #1 qd up to 7 days

    3. Oint triamcinolone #1 qd

    4. if complicated

        1. Tab fluconazole 150mg #3 for 3 days

        2. Vaginal cream clotrimazole 1% #1 qd for 7 days

    5. if recurrent for 4 times/year

        1. Tab fluconazole 150mg #30 weekly

        2. vaginal cream clotrimazole 1% #1 qd for 7 days

    6. multiple recurrence or non-albicans candida

        1. Cap boric acid 600mg #14 qhs

Brucellosis

#

1. Symptoms:

    1. prolong fever

    2. myalgia

    3. back pain

    4. malaise

2. lab data

    1. Wright ≥1/160, if negative: repeat 2 weeks later or use coombs wright

    2. 2ME

3. Treatment:

    1. tab doxycycline 100 bid #90 (may cause esophagitis)

    2. Amp streptomycin 1gr qd IM #14

        1. or Cap rifampin 300mg 2tabs before breakfast #90

    3. treat for 6 weeks

4. If relapses: treat for 12 weeks with:

    1. tab ciprofloxacin 500 mg bid #90

    2. Cap rifampin 300 mg 2 tabs before breakfast #90

    3. Tab cotrimoxazole 400 mg 2 tab bid #180

5. For pregnant pt:

    1. cap rifampin 300 mg 2 tab before breakfast #90

    2. Tab doxycycline 100 mg bid #90

6. Prophylaxis:

    1. Cap rifampin 300 mg 2 tabs before breakfast #90

    2. tab doxycycline 100 mg bid #90

Blepharitis

#

1. Etiology: Staph

2. DDx:

    1. Herpes

    2. cellulitis

    3. Hordeolum

3. Symptoms

    1. Erythema

    2. redness

    3. xerophthalmia

    4. lacrimation

    5. foreign body sensation

4. Treatment

    1. Baby shampoo tds

        1. or shampoo tea tree oil tds

    2. Oint opht Hydrocortisone 1# #1 qd, prescribe with caution due to possibilty of atrophy

    3. Drop opht Sulfacetamide #1 qid 1 drop

    4. Oint opht erythromycin #1 tds

    5. warm compress for 10 mins qid

    6. For very severe cases:

        1. Cap doxycycline 100mg bid for 2 weeks

Bacterial vaginitis

#

1. symptoms:

    1. malodor, whitish or grayish with fish odor discharges

    2. mostly may be treated along with another type of vaginitis

    3. R/O cystitis

2. treatment:

    1. Tab metronidazole 500mg #14 bid

        1. or vaginal gel metronidazole 0.75% #1 qhs for 5 nights

        2. or cream vaginal clindamycin 2% #1 qhs for 7 nights

    2. if relapsed:

        1. Tab metronidazole 500 mg #28 bid

Bacterial conjunctivitis

#

1. usually unilaterally affected with pussy discharges

2. Treatment

    1. Oint opht erythromycin 0.5% #1 qid

        1. or drop opht ciprofloxacin qd

    2. drop tear opht artificial 0.5% #1 qid

    3. drop opht sulfacetamide 10% #1 qid 2drops

Asymptomatic bacteriuria in pregnancy

1. treatment

    1. cap amoxicillin 500mg #12 qid

        1. or tab cefixime 200mg #7 qd

    2. repeat U/A and U/C after 2 weeks

    3. if relapsed:

        1. Tab nitrofurantoin 100mg #100 qd till end of pregnancy

Ascaris, Pinworm (Enterobius vermicularis)

#

1. Ascaris

    1. Dx: ova in feces

    2. treatment:

        1. Tab albendazole 400 mg #2 single dose

            1. or tab mebendazole 100 mg #5 single dose

        2. in children or pregnancy use:

            1. Syrup pyrantel 250mg/5ml #1 11mg/kg for adults single dose, w/4 cc single dose for child

        3. repeat treatment 2 weeks later

2. Enterobius vermicularis

    1. Dx: itching in anal

    2. Treatment

        1. tab mebendazole 100 mg 2 tab SD

            1. or tab albendazole 400 mg 2 tab SD

        2. repeat treatment 2 weeks later

Amebiasis

1. Symptoms:

    1. 38% with fever

    2. diarrhea

    3. OB +

    4. weight loss

    5. crampy abdominal pain

2. check

    1. S/E, OB/OP

    2. U/A, U/C

3. Treatment

    1. for adults

        1. Tab mebendazole 500-750mg tds for 7-10days

            1. or Tab tinidazole 500 mf qid for 3 days

        2. Tab iodoquinol 210mg 3tabs tds for 20 days

    2. for children

        1. susp metronidazole 35-50mg /kg/day tds for 7 days (susp 125mg/5cc)

            1. or syrup paromomycin 25-30mg/kg/day tds for 7 days