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::::* Preferred regimen:combination therapy with both praziquantel (50 mg/kg/day) and albendazole (15 mg/kg/day).
::::* Preferred regimen:combination therapy with both praziquantel (50 mg/kg/day) and albendazole (15 mg/kg/day).


::::*  Cysticercal encephalitis
::::*  Cysticercal encephalitis  
Cysticercal encephalitis (diffuse cerebral edema associated with multiple inflamed cysticerci) is a contraindication for antiparasitic therapy, since enhanced parasite killing can exacerbate host inflammatory response and lead to diffuse cerebral edema and potential transtentorial herniation [10,41,42]. Most cases of cysticercal encephalitis improve with corticosteroid therapy




Revision as of 16:13, 23 July 2015






Neurocysticercosis

  • Neurocysticercosis treatment
  • 1. Parenchymal neurocysticercosis
  • 1.1 Single lesions[1]
  • Preferred regimen:antiparasitic therapy (eg, albendazole 15 mg/kg/day for 3 to 8 days) and a short course of corticosteroids (eg, prednisone 1 mg/kg/day for 8 to 10 days followed by a taper)
  • 1.2 Multiple cysts
  • Preferred regimen:most favor treatment of multiple viable, parenchymal cysticerci with antiparasitic therapy (albendazole 15 mg/kg/day in two daily doses for 8 to 15 days) administered together with high-dose steroids
  • Preferred regimen:combination therapy with both praziquantel (50 mg/kg/day) and albendazole (15 mg/kg/day).
  • Cysticercal encephalitis

Cysticercal encephalitis (diffuse cerebral edema associated with multiple inflamed cysticerci) is a contraindication for antiparasitic therapy, since enhanced parasite killing can exacerbate host inflammatory response and lead to diffuse cerebral edema and potential transtentorial herniation [10,41,42]. Most cases of cysticercal encephalitis improve with corticosteroid therapy


Parasites – Ectoparasites

  • Body lice
  • Pediculus humanus, corporis treatment[2]
  • A body lice infestation is treated by improving the personal hygiene of the infested person, including assuring a regular (at least weekly) change of clean clothes.
  • Clothing, bedding, and towels used by the infested person should be laundered using hot water (at least 130°F) and machine dried using the hot cycle.
  • Sometimes the infested person also is treated with a pediculicide Ivermectin Lotion; however, a pediculicide Ivermectin generally is not necessary if hygiene is maintained and items are laundered appropriately at least once a week. A pediculicide Ivermectin should be applied exactly as directed on the bottle or by your physician.
  • Head lice
  • Pediculus humanus, capitis treatment[3]
  • Preferred regimen (1): Permethrin 1% lotion apply to shampooed dried hair for 10 min.; repeat in 9-10 days
  • Preferred regimen (2): Malathion 0.5% lotion (Ovide) apply to dry hair for 8–12hrs, then shampoo. 2 doses 7-9 days apart
  • Alternative regimen: Ivermectin 200 μg/kg PO once; 3 doses at 7 day intervals reported effective.
  • Pubic lice
  • Phthirus pubis treatment[4]
  • Preferred regimen (1): Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
  • Preferred regimen (2): Pyrethrins with piperonyl butoxide applied to the affected area and washed off after 10 minutes
  • Alternative regimen (1): Malathion 0.5% lotion applied to affected areas and washed off after 8–12 hours
  • Alternative regimen (2): Ivermectin 250 ug/kg PO, repeated in 2 weeks
  • Preferred regimen: No medications approved by the FDA are available for treatment[5]
  • Note: Fly larvae need to be surgically removed.
  • Fly larvae treatment [6]
  • 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.
  • Note (1): Myiasis is due to larvae of flies.
  • Note (2): Usually cutaneous/subcutaneous nodule with central punctum.

Scabies

  • Scabies
  • Sarcoptes scabiei treatment [7]
  • 1. Adult
  • Preferred regimen (1): Permethrin 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
  • Preferred regimen (2): Ivermectin 200ug/kg PO qd and repeated in 2 weeksAlternative Regimens
  • Alternative regimen: Lindane (1%) 1 oz of lotion or 30 g of cream applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours
  • Infants and young children
  • Preferred regimen: Permethrin 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
  • Note: Infants and young children aged< 10 years should not be treated with lindane.
  • 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
* preferred regimen (for Norwegian scabies) : Permethrin 5% cream-2 or more applications a week apart may be needed. After each Permethrin dose (days 2-7) apply 6% Sulfur in petrolatum.
Note: Apply entire skin from chin down to and including toes with Permethrin 5% cream. Leave on 8–14hours. Repeat if itching persists for >2-4 wks after treatment or new pustules occur.

Sparganosis

  • Sparganosis (Spirometra mansonoides) treatment [8]
  • Preferred treatment: Surgical resection or ethanol injection of subcutaneous masses
Note: Source for Spirometra mansonoides larval cysts is frogs or snakes
  1. ↑ García HH, Evans CA, Nash TE, Takayanagui OM, White AC, Botero D; et al. (2002). "Current consensus guidelines for treatment of neurocysticercosis". Clin Microbiol Rev. 15 (4): 747–56. PMC 126865. PMID 12364377.
  2. ↑ Template:CDC
  3. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
  4. ↑ Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
  5. ↑ "Parasites - Myiasis".
  6. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
  7. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
  8. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
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